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Human leukocyte antigen compatibility and lymphocyte cross‐matching play no significant role in the current adult‐to‐adult living donor liver transplantation
Author(s) -
Badawy Amr,
Kaido Toshimi,
Yoshizawa Atsushi,
Yagi Shintaro,
Fukumitsu Ken,
Okajima Hideaki,
Uemoto Shinji
Publication year - 2018
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.13234
Subject(s) - medicine , human leukocyte antigen , transplantation , liver transplantation , abo blood group system , immunology , histocompatibility , histocompatibility testing , antigen , gastroenterology
Background The impact of human leukocyte antigen (HLA) compatibility and positive lymphocyte cross‐match ( LCM ) on organ transplantation is well‐recognized particularly in kidney and heart transplantation; however, it is still debatable in liver transplantation ( LT ). So, the aim of this study was to evaluate the impact of HLA mismatch and positive LCM on the outcome of LT . Methods We retrospectively analyzed the data of all adult recipients who underwent living donor LT at our institute between January 2010 and July 2016. We excluded all ABO blood group incompatible LDLT patients and patients with incomplete data regarding HLA genotyping (n = 134). The type and degree of HLA ‐A, HLA ‐B, HLA ‐C, HLA ‐ DR , HLA ‐ DQ mismatch and LCM were assessed in each donor‐recipient pair and their relationship to the occurrence of rejection, CMV infection and graft survival was evaluated. Results A higher percentage (>50%) of donor‐recipient pairs had 1 HLA mismatch at each locus in the host‐vs‐graft direction and seventeen recipients (13%) had positive LCM . Human leukocyte antigen mismatch and positive LCM were not correlated with increased incidence of acute rejection ( P = .37, P = .6, respectively), CMV infection post‐transplant ( P = .52, P = .76, respectively), or graft failure ( HR 1.22, P = .68 and HR 1.73, P = .34, respectively). Conclusion Positive LCM and HLA mismatches did not affect the overall graft survival after adult‐to‐adult LDLT and should not be considered as contraindications for liver transplantation.