Year 2021 / Volume 113 / Number 8
Original
Long-term outcomes and clinical impact of anti-HLA donor-specific antibodies (DSA) after liver transplantation: a prospective study in a pilot cohort

557-562

DOI: 10.17235/reed.2020.7337/2020

Aranzazu Caballero Marcos, Raquel Díaz Ruiz, Mario Romero Cristóbal, Ainhoa Fernández Yunquera, Fernando Díaz-Fontenla, Leticia Pérez Carazo, María Isabel Peligros Gómez, José Luis Vicario Moreno, Magdalena Salcedo Plaza, Rafael Bañares Cañizares,

Abstract
Introduction: the presence of donor-specific antibodies (DSA) is thought to affect survival of the allograft and patient after liver transplantation (LT). However, their significance is not well understood. Patients and methods: a prospective study was performed of 32 adult patients who underwent LT in 2011 to analyze the existence of DSA, associated risk factors and medium-term impact. Immunological determinations were performed immediately before LT and at three, six, 12 months and five years after LT. Results: eight patients (24.2 %) presented pre-formed DSA. However, titers were negative in all patients five years after LT and there were no associated events. Eight out of 24 patients (33.3 %) developed de novo DSA. After five years, only two remained positive; both were class II with high mean fluorescence intensity (MFI) values at diagnosis (over 15,000). No association was found between the development of DSA and the risk of rejection, graft loss or death. However, an increase in liver stiffness values was observed in patients with persistent DSA, and focal sinusoidal deposition of C4d and moderate liver fibrosis were reported. Conclusion: the incidence of DSA is high after LT. In addition, the persistence of de novo DSA could be associated with silent liver fibrosis with a potential impact on graft outcomes.
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Caballero Marcos A, Díaz Ruiz R, Romero Cristóbal M, Fernández Yunquera A, Díaz-Fontenla F, Pérez Carazo L, et all. Long-term outcomes and clinical impact of anti-HLA donor-specific antibodies (DSA) after liver transplantation: a prospective study in a pilot cohort. 7337/2020


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Publication history

Received: 12/06/2020

Accepted: 28/08/2020

Online First: 27/11/2020

Published: 28/07/2021

Article revision time: 74 days

Article Online First time: 168 days

Article editing time: 411 days


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