Maternal microchimerism in patients with biliary atresia

Nijagal, Amar; Fleck, Shannon; MacKenzie, Tippi C.

doi:10.4161/chim.20152

Cited by 9 publications

(10 citation statements)

References 25 publications

(25 reference statements)

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“…In LT, Nijagal et al . found that in pediatric LDLT for BA, recipients receiving maternal grafts had lower rates of graft failure and refractory rejection than those receiving paternal grafts, and maternal microchimerism may have been responsible for the observed tolerance . In our present study, a multivariate analysis showed that only gender mismatch was independently correlated with ACR ( P = 0.016).…”

Section: Discussionsupporting

confidence: 54%

Maternal grafts protect daughter recipients from acute cellular rejection after pediatric living donor liver transplantation for biliary atresia

et al. 2014

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SummarySome studies have found that gender mismatch between donors and recipients are related to poor graft prognosis after liver transplantation. However, few studies have investigated the impact of gender mismatch on acute cellular rejection (ACR) in pediatric living donor liver transplantation (LDLT). This retrospective study investigated the clinical significance of these factors in ACR after pediatric LDLT. Between November 2001 and February 2012, 114 LDLTs were performed for recipients with biliary atresia (BA) using parental grafts. We performed univariate and multivariate analyses to identify the factors associated with ACR. The donor-recipient classifications included mother donor to daughter recipient (MD; n = 43), mother to son (n = 18), father to daughter (FD; n = 33), and father to son (n = 20) groups. The overall incidence rate of ACR in the recipients was 36.8%. Multivariate analysis showed that gender mismatch alone was an independent risk factor for ACR (P = 0.012). The FD group had a higher incidence of ACR than the MD group (P = 0.002). In LDLT, paternal grafts with gender mismatch were associated with a higher increased incidence of ACR than maternal grafts with gender match. Our findings support the possibility that maternal antigens may have an important clinical impact on graft tolerance in LDLT for patients with BA.

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Section: Discussionsupporting

confidence: 54%

Maternal grafts protect daughter recipients from acute cellular rejection after pediatric living donor liver transplantation for biliary atresia

et al. 2014

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“…Nijagal et al[ 15 ] reported beneficial effects of maternal graft in patients with BA, in terms of decreased risk of hepatic graft failure. Furthermore, it was suggested that these patients with BA exhibit allograft tolerance to maternal grafts[ 15 , 23 , 24 ]. Sanada et al[ 24 ] described the importance of sex matching of parental grafts; in particular, the authors showed that maternal grafts were associated with lower incidence of acute cellular rejection than paternal grafts in daughters.…”

Section: Discussionmentioning

confidence: 99%

“…As patients with BA were found to exhibit increased number of maternal cells and inflammation of the biliary tree in their livers, the disease was viewed as an inflammatory disease of fetal-maternal circulation; further, graft-versus-host reaction was proposed to represent the underlying pathophysiology of BA[ 20 - 22 ]. Accordingly, beneficial effects of maternal liver grafts have been demonstrated in patients with BA, but not in non-BA LT recipients[ 15 , 23 , 24 ]. However, in these studies, donors were analyzed by parental relationship (maternal vs paternal) to the recipient, and the presence or absence of maternal MC was not tested.…”

Section: Discussionmentioning

confidence: 99%

Pretransplantation fetal-maternal microchimerism in pediatric liver transplantation from mother

Park

Song

et al. 2017

WJG

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AIMTo investigate the rates of pretransplantation fetal-maternal microchimerism (MC) and its effect on rejection in children receiving maternal liver grafts.METHODSDNA or blood samples before liver transplantation (LT) were available in 45 pediatric patients and their mothers. The presence of pretransplantation MC to non-inherited maternal antigens (NIMAs) (NIMA-MC) in the peripheral blood was tested using nested PCR-single-strand conformation polymorphism analysis for the human leukocyte antigen (HLA)-DRB1 alleles. NIMA-MC was successfully evaluated in 26 of the 45 children. Among these 45 pediatric LT recipients, 23 children (51.1%) received transplants from maternal donors and the other 22 from non-maternal donors.RESULTSAmong these 26 children, pretransplantation NIMA-MC was detected in 23.1% (n = 6), 6.1 (range, 0.8-14) years after birth. Among the children with a maternal donor, the rate of biopsy-proven cellular rejection (BPCR) was 0% in patients with NIMA-MC positivity (0/3) and those with HLA-DR identity with the mother (0/4), but it was 50% in those with NIMA-MC negativity (5/10). Patients with NIMA-MC positivity or HLA-DR identity with the mother showed significantly lower BPCR rate compared with NIMA-MC-negative patients (0% vs 50%, P = 0.04). NIMA-MC-positive patients tended to show lower BPCR rate compared with NIMA-MC-negative patients (P = 0.23).CONCLUSIONThe presence of pretransplantation NIMA-MC or HLA-DR identity with the mother could be associated with BPCR-free survival in pediatric recipients of LT from maternal donors.

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“…This beneficial effect was not found in patients receiving liver transplant but with a different underlying disease than biliary atresia. [67,68] They pointed out that MMc and NIMA exposure might be increased in patients with biliary atresia, playing beneficial tolerogenic effect in the context of transplantation and also probably having a pathogenic impact in development of this disease.…”

Section: Other Aspects Of MC and Nima Effectmentioning

confidence: 99%