High mean fluorescence intensity donor-specific anti-HLA antibodies associated with chronic rejection Postliver transplant.
High mean fluorescence intensity donor-specific anti-HLA antibodies associated with chronic rejection Postliver transplant.
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DOI：
10.1111/j.1600-6143.2011.03593.x
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发表时间：
2011-09
期刊：
影响因子：
--
通讯作者：
Terasaki PI
中科院分区：
文献类型：
--
作者：
O'Leary JG;Kaneku H;Susskind BM;Jennings LW;Neri MA;Davis GL;Klintmalm GB;Terasaki PI
与肾移植（供者特异性抗HLA抗体（DSA）对移植物存活率产生负面影响）相反，原位肝移植（奥尔特）后患者DSA与临床结局的相关性尚未明确确定。我们假设DSA存在于奥尔特后发生慢性排斥反应的患者中。普罗帕酮收集了39例经活检证实为慢性排斥反应的原发性奥尔特患者的系列血清样本，并对39例对照患者设盲，并使用LABScreen单抗原珠测试分析DSA，其中1000平均荧光值被认为是阳性。在研究患者中，中位移植物生存期为15个月，74%接受了≥ 1次再次移植，20%存活，87%发生了≥ 1次急性排斥反应。这与对照组患者形成对比，对照组患者中69%仍然存活，没有患者需要再次移植或发生排斥反应。36例慢性排斥患者（92%）和24例对照患者（61%）接受了DSA（p = 0.003）。与对照组相比，慢性排斥患者的DSA平均荧光强度（MFI）更高。虽然需要更多患者的进一步研究来确定临床上有意义的阈值，但高MFI DSA与奥尔特后慢性排斥反应存在相关性。
In contrast to kidney transplantation where donorspecific anti-HLA antibodies (DSA) negatively impact graft survival, correlation of DSA with clinical outcomes in patients after orthotopic liver transplantation (OLT) has not been clearly established. We hypothesized that DSA are present in patients who develop chronic rejection after OLT. Prospectively collected serial serum samples on 39 primary OLT patients with biopsy-proven chronic rejection and 39 comparator patients were blinded and analyzed for DSA using LABScreen single antigen beads test, where a 1000 mean fluorescence value was considered positive. In study patients, the median graft survival was 15 months, 74% received ≥ one retransplant, 20% remain alive and 87% had ≥ one episode of acute rejection. This is in contrast to comparator patients where 69% remain alive, and no patient needed retransplant or experienced rejection. Thirty-six chronic rejection patients (92%) and 24 (61%) comparator patients had DSA (p = 0.003). Chronic rejection versus comparator patients had higher mean fluorescence intensity (MFI) DSA. Although a further study with larger numbers of patients is needed to identify clinically significant thresholds, there is an association of high-MFI DSA with chronic rejection after OLT.
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