Premium
Immunosuppression with mTOR inhibitors prevents the development of donor‐specific antibodies after liver transplant
Author(s) -
Willuweit Katharina,
Heinold Andreas,
RashidiAlavijeh Jassin,
Heinemann Falko M.,
Horn Peter A.,
Paul Andreas,
Gerken Guido,
Herzer Kerstin
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12974
Subject(s) - medicine , everolimus , immunosuppression , liver transplantation , sirolimus , hepatocellular carcinoma , antibody , gastroenterology , incidence (geometry) , chronic liver disease , transplantation , immunology , cirrhosis , physics , optics
Background Donor‐specific antibodies ( DSA s) are an important cause of complications after solid organ transplant. Risk factors and, thus, strategies for preventing DSA development are not well defined. Methods The DSA status of 400 patients who underwent liver transplant ( LT ) at the outpatient clinic of the University Hospital Essen was determined. Human leukocyte antigen ( HLA ) antibodies were detected by single‐antigen bead technology. The strength of DSA s was reported as mean fluorescence intensity. Results Detectable DSA s were found in 74 (18.5%) patients and significantly more often in patients who underwent LT for autoimmune liver disease than for all other indications (29.3%; P =.022), but significantly less often found in patients who underwent LT for hepatocellular carcinoma (7.6%, P =.005). The incidence of DSA s increased with time after LT , and the risk was generally higher for female patients. The frequency of DSA detection was significantly lower (10.6%) for patients receiving immunosuppressive treatment with mammalian target of rapamycin ( mTOR ) inhibitors than for those receiving other regimens (20.5%; P =.025). Conclusion Autoimmune liver diseases, female sex, and time of more than 8 years since LT predispose patients to the development of DSA s. Immunosuppression with the mTOR inhibitor everolimus protects against DSA development after liver transplant.