Impact of donor-specific antibodies on long-term graft survival with pediatric liver transplantation

作     者：Felicitas Leonie Schotters Jan Beime Andrea Briem-Richter Thomas Binder Uta Herden Enke Freya Grabhorn 

作者机构：Department of Pediatric Hepatology and Liver TransplantationUniversitätsklinikum Hamburg-EppendorfHamburg 20246Germany Department of Transfusion MedicineHuman Leucocyte Antigen LaboratoryUniversity Medicine RostockRostock 18057Germany Department of Hepatobiliary&Transplant SurgeryUniversitätsklinikum Hamburg-EppendorfHamburg 20246Germany 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第6期

页      面：673-685页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：Donor-specific antibodies Graft rejection Liver transplantation Fluoroimmunoassay Pediatrics Graft dysfunction Fibrosis 

摘      要：BACKGROUND In a previous paper,we reported a high prevalence of donor-specific antibody(DSA)in pediatric patients with chronic rejection and expressed the need for confirmation of these findings in a larger *** To clarify the importance of DSAs on long-term graft survival in a larger cohort of pediatric *** We performed a retrospective analysis of 123 pediatric liver transplantation(LT)recipients who participated in yearly follow-ups including Luminex testing for DSA at our *** cohort was split into two groups according to the DSA status(DSA-positive n=54,DSA-negative n=69).Groups were compared with regard to liver function,biopsy findings,graft survival,need for re-LT and immunosuppressive *** DSA-positive pediatric patients showed a higher prevalence of chronic rejection(P=0.01),fibrosis(P0.001)and re-transplantation(P=0.018)than DSA-negative *** II DSAs particularly influenced graft *** DQ2,DQ7,DQ8 and DQ9 might serve as indicators for the risk of chronic rejection and/or allograft *** fluorescence intensity levels and DSA number did not impact graft *** episodes of chronic rejection might lead to DSA *** DSA prevalence significantly affected long-term liver allograft performance and liver allograft survival in our cohort of pediatric *** for class II DSAs in combination with assessment of protocol liver biopsies for chronic antibodymediated rejection improved early identification of patients at risk of graft loss.