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Impact of human leukocyte antigen compatibility on outcomes of living donor liver transplantation: Experience from a tertiary care center
Author(s) -
Mittal Siddharth,
Sinha Piyush,
Sarin Shashwat,
Rastogi Archana,
Gupta Ekta,
Bajpai Meenu,
Pamecha Viniyendra,
Trehanpati Nirupma
Publication year - 2021
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13644
Subject(s) - medicine , human leukocyte antigen , sepsis , histocompatibility , transplantation , retrospective cohort study , liver transplantation , abo blood group system , single center , histocompatibility testing , immunology , antigen
The role of HLA compatibility in kidney, heart, and stem cell transplantation is well known, but with regard to living donor liver transplantation (LDLT), there is a different scenario. In the present study, we aim to examine the effects of donor‐recipient HLA mismatches at A, B, and DR loci on various outcomes of LDLT‐like graft survival, early allograft dysfunction (EAD), acute rejection, length of hospital (LOH) stay, sepsis, and cytomegalovirus (CMV) reactivation. Methods This is a retrospective single center study of a cohort of adult patients who underwent first time ABO‐compatible (ABOc) LDLT between January 2010 and December 2018. Transplants with incomplete records or without HLA typing data were excluded. Donor‐recipient HLA‐A, B, and DR mismatches were assessed in the host versus graft (HVG) direction and were correlated with various post‐transplant outcomes. Results Among 140 transplants being evaluated, approximately two third had total HLA mismatches between 2 and 3. HLA mismatches at each locus as well as cumulative HLA mismatches did not show any association with overall graft survival, EAD, acute rejection episodes, and LOH stay. However, the presence of minimum one mismatch at HLA‐A and DR loci was associated with the development of CMV reactivation ( P = .03) and sepsis ( P = .02) post‐LDLT respectively. Conclusion HLA mismatch is not associated with acute rejection, early graft dysfunction, and overall survival in LDLT. Its impact on CMV reactivation and sepsis needs further evaluation.