The impact of preformed donor-specific antibodies in living donor liver transplantation according to graft volume

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Abstract

Introduction: The roles of preformed anti-HLA donor-specific antibodies (DSAs) in liver transplantation remain controversial. We evaluated the impact of preformed DSAs in living donor liver transplantation. Methods: Adults who underwent living donor liver transplantation (n = 175) in our institute were included in this study. Lymphocyte cytotoxicity test (LCT), flow cytometric crossmatch (FCXM), and single-antigen bead assays were performed. Results: Among adult living donor liver transplantation recipients, 27 (16.5%) and 14 (8.5%) had pretransplant FCXM-positive findings and LCT-positive findings, respectively. FCXM-positive patients displayed a significantly worse 5-year graft survival rate (77.3%; vs. DSA-negative, 91.6%). Six of 14 LCT-positive patients exhibited graft loss shortly after transplantation (5-year survival rate: 57.1%). All LCT-positive patients with graft loss underwent left lobe living donor liver transplantation. Significantly lower ratio of graft volume relative to standard liver volume (32.9 ± 5.7%) and smaller graft size (365.3 ± 57.9 g) were observed in patients with graft loss (p

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Goto, R., Ito, M., Kawamura, N., Watanabe, M., Ganchiku, Y., Kamiyama, T., … Taketomi, A. (2022). The impact of preformed donor-specific antibodies in living donor liver transplantation according to graft volume. Immunity, Inflammation and Disease, 10(3). https://doi.org/10.1002/iid3.586

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