Flow cytometric analysis of antidonor-specific antibodies in liver transplant

Human leukocyte antigen compatibility and lymphocyte cross‐matching play no significant role in the current adult‐to‐adult living donor liver transplantation

“…10,[32][33][34][35] The reason for the difference of liver transplantation from other organs transplantation is that the liver is well-known to be an immunetolerant organ. There are several mechanisms assumed to elucidate that 36,37 : (i) presence of soluble HLA class I molecules that attach to preformed antibodies forming immune complexes, which are removed by Kupffer cells, thus preventing their harmful effect; (ii) Kupffer cell phagocytosis that eliminates platelets aggregates and immune complexes; (iii) scanty distribution of HLA class II antigens in the microvasculature; (iv) the double blood supply that protects against ischemic liver damage and the extensive liver regenerative capacity; (v) the capacious endothelial surface that can clear all circulating antibodies.…”

De Novo Donor-Specific HLA Antibodies Decrease Patient and Graft Survival in Liver Transplant Recipients

“…Although pre‐transplant DSA's impact on outcome has been evaluated numerous times, the importance of DSA after liver transplantation has more limited data. Only in recent years have studies suggested that post‐liver transplant DSA may play a role in acute and chronic rejection . One of the first studies to link the role of alloantibodies and chronic rejection was published by Demetris et al where they showed 7 of 22 patients with chronic rejection had high PRA (panel reactive antibodies) peri‐transplant and the majority showed deposition of Ig or complement components in the rejected liver tissue.…”

“…One of the first studies to link the role of alloantibodies and chronic rejection was published by Demetris et al where they showed 7 of 22 patients with chronic rejection had high PRA (panel reactive antibodies) peri‐transplant and the majority showed deposition of Ig or complement components in the rejected liver tissue. Later, Piazza et al showed that 65% of liver transplant recipients had DSA after transplant, and this was associated with rejection. Kasahara et al demonstrated that if patients had DSA within the first month after transplant, 100% experienced rejection, compared to only 17% if no DSA was found.…”

De NovoDonor-Specific HLA Antibodies Decrease Patient and Graft Survival in Liver Transplant Recipients

“…Although pre-transplant DSA's impact on outcome has been evaluated numerous times, the importance of DSA after liver transplantation has more limited data. Only in recent years have studies suggested that post-liver transplant DSA may play a role in acute and chronic rejection (20)(21)(22)(23)(24)(25). One of the first studies to link the role of alloantibodies and chronic rejection was published by Demetris et al (20) where they showed 7 of 22 patients with chronic rejection had high PRA (panel reactive antibodies) peri-transplant and the majority showed deposition of Ig or complement components in the rejected liver tissue.…”

“…One of the first studies to link the role of alloantibodies and chronic rejection was published by Demetris et al (20) where they showed 7 of 22 patients with chronic rejection had high PRA (panel reactive antibodies) peri-transplant and the majority showed deposition of Ig or complement components in the rejected liver tissue. Later, Piazza et al (21) showed that 65% of liver transplant recipients had DSA after transplant, and this was associated with rejection. Kasahara et al (22) demonstrated that if patients had DSA within the first month after transplant, 100% experienced rejection, compared to only 17% if no DSA was found.…”