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UCLA Liver Transplantation: Analysis of Immunological Factors Affecting Outcome
Author(s) -
Dawson Sherfield,
Imagawa David K.,
Johnson Cheryl,
Cecka Michael,
Terasaki Paul I.,
Shackleton Christopher R.,
Busuttil Ronald W.
Publication year - 1996
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1996.tb00642.x
Subject(s) - medicine , gastroenterology , liver transplantation , hepatitis b , panel reactive antibody , transplantation , surgery , kidney transplantation
From 1988 to 1993, UCLA completed 938 first and 1,146 total orthotopic liver transplants (OLT). Race analysis demonstrated a 1‐year patient survival of 89% in Blacks (n = 45) versus 80% in Whites (n = 492, p < 0.02), with no significant difference shown between His‐panics (n = 278) and Whites. The 1‐year patient survival in Asians was 50% (n = 58, p < 0.02 vs. Whites) even when hepatitis B was excluded (59%, n = 43). The 1‐year patient survival of hepatitis B surface antigen positive Asians (n = 15) was only 21% (p < 0.02 vs. all others). OLT patients whose panel reactive antibody (PRA) was < 10% (n = 339) demonstrated no graft or patient survival advantage versus recipients whose PRA was >10% (n = 71). A positive antidonor flow cytometry crossmatch (>30 mean channel shifts, n = 76) was associated with a decreased 1‐year graft survival (56% vs. 73%, p < 0.05) when compared to flow negative recipients (n = 185). Graft survival for 0 DR mismatches was 74% at 1 year compared with 57% for 1 DR mismatche (p < 0.02) and 59% for 2 DR mismatches (p < 0.02).