Long-term outcomes and clinical impact of anti-HLA donor-specific antibodies (DSA) after liver transplantation: prospective study in a pilot cohort.
Long-term outcomes and clinical impact of anti-HLA donor-specific antibodies (DSA) after liver transplantation: prospective study in a pilot cohort.
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肝移植后抗 HLA 供体特异性抗体 (DSA) 的长期结果和临床影响：试点队列的前瞻性研究。
DOI：
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发表时间：
2020
影响因子：
2
通讯作者：
Rafael Bañares Cañizares
中科院分区：
文献类型：
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作者：
Aránzazu Caballero Marcos;Raquel Díaz Ruiz;Mario Romero Cristóbal;A. Fernández Yunquera;Fernando Díaz Fontenla;L. Pérez Carazo;M. I. Peligros Gómez;Jose Luis Vicario Moreno;M. Salcedo Plaza;Rafael Bañares Cañizares
供者特异性抗体（DSA）的存在被认为是影响肝移植（LT）后移植物和患者存活的重要因素。然而，它们的意义并没有得到很好的理解。我们对2011年接受LT的32例成人患者进行了一项前瞻性研究，以分析DSA的存在、相关风险因素和中期影响。术前、术后3、6、12个月和5年分别行免疫学检查。8例（24.2%）患者行DSA检查。然而，LT后5年，所有患者的滴度均为阴性，且无相关事件。24例患者中有8例（33.3%）发生了新发DSA。5年后，只有2例仍为阳性; 2例均为II级，诊断时MFI值较高（超过15 000）。DSA的发展与排斥反应、移植物丢失或死亡的风险之间没有相关性。然而，在持续DSA患者中观察到肝脏硬度值增加;在其中一例患者中，我们记录到C4d局灶性窦状沉积和中度肝纤维化。总之，LT后DSA的发生率很高。此外，新发DSA的持续性可能与无症状肝纤维化相关，对移植物结局有潜在影响。
The presence of donor-specific antibodies (DSA) has been considered to affect survival of allograft and patient after liver transplantation (LT). However, their significance is not well understood. We performed a prospective study of 32 adult patients who underwent LT in 2011 to analyse the existence of DSA, associated risk factors, and medium-term impact. Immunological determinations were performed immediately before LT and at 3, 6, 12 months and 5 years after LT. Eight patients (24.2%) presented preformed DSA. However, titres were negative in all patients 5 years after LT and there were no events associated. Eight out of 24 patients (33.3%) developed de novo DSA. After 5 years, only 2 remained positive; both were class II with high MFI values at diagnosis (over 15 000). No association was found between development of DSA and risk of rejection, graft loss, or death. However, an increase in liver stiffness values was observed in patients with persistent DSA; in one, we recorded focal sinusoidal deposition of C4d and moderate liver fibrosis. In 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 potential impact on graft outcomes.
在环孢素或 FK 506 治疗下原代人同种异体肝脏移植物中出现阳性交叉配型。
影响因子：
0.9
作者：
Takaya,S;Duquesnoy,R;Iwaki,Y;Demetris,J;Yagihashi,A;Bronsther,O;Iwatsuki,S;Starzl,TE
通讯作者：
Starzl,TE