AI Article Synopsis

  • The study explored the long-term effects of donor-specific human leukocyte antigen (HLA) class 2 antibodies (DSA cl 2) on liver transplant recipients, involving 156 participants (44 pediatric and 112 adult).
  • Nearly half (46%) of recipients tested positive for DSA cl 2 after an average follow-up of 15 years, which was linked to higher levels of graft fibrosis and a greater incidence of chronic rejection compared to DSA cl 2 negative patients.
  • The findings suggest that the presence of DSA cl 2 is associated with immunosuppressive monotherapy, leading to worse outcomes like increased graft fibrosis and the risk of graft loss.

Article Abstract

Here the impact of donor specific human leukocyte antigen (HLA) class 2 antibodies (DSA cl 2) on long term outcome after liver transplantation (LT) was investigated. Altogether 156 (44 pediatric and 112 adult) LT recipients were included in the study. Graft fibrosis was assessed by liver elastography and biopsy. DSA cl 2 were determined by Luminex technology. 46% of LT recipients were positive for DSA cl 2 after a median follow-up of 15 years. In the multivariate analysis DSA cl 2 were significantly associated with immunosuppressive monotherapy (OR 5.42; 95% CI: 1.02-28.90; p = .048). Compared to DSA cl 2 negative patients, positive recipients had significantly more graft fibrosis based on the liver stiffness (mean 9.4 ± 9.0 kPa vs. 6.5 ± 6.3 kPa; p < .002) and fibrosis stages determined by liver elastography (p = .016) and the performed liver biopsies (p = .002). Also, a significantly higher incidence of chronic rejections (11% vs. 2%; p = .045) and graft losses (6% vs. 0%; p = .043) were found. In the multivariate regression analysis DSA cl 2 were significantly associated with graft fibrosis (OR 4.57; 95% CI 1.59-13.10; p = .005). So, these data suggest that development of DSA cl 2 occurs more often with immunosuppressive monotherapy and may ultimately result in chronic rejection and graft fibrosis.

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Source
http://dx.doi.org/10.1111/ctr.14336DOI Listing

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