TY - JOUR
T1 - Association of post-transplant donor-specific HLA antibody with liver graft fibrosis during long-term follow-up after pediatric liver transplantation
AU - Tokodai, Kazuaki
AU - Miyagi, Shigehito
AU - Nakanishi, Chikashi
AU - Hara, Yasuyuki
AU - Nakanishi, Wataru
AU - Miyazawa, Koji
AU - Shimizu, Kenji
AU - Murakami, Keigo
AU - Sasano, Hironobu
AU - Goto, Masafumi
AU - Unno, Michiaki
AU - Kamei, Takashi
N1 - Funding Information:
The authors thank Naoko Saito and Chikako Sato for their excellent assistance. This study, particularly the analysis and writing of the manuscript, was supported by JSPS KAKENHI (grant nos. JP26861036 and JP17K16502).
Publisher Copyright:
© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2018/5
Y1 - 2018/5
N2 - The aim of this study was to evaluate the significance of post-transplant DSA as a predictor of liver fibrosis during long-term follow-up after pediatric LT. We evaluated the histological findings in 18 LT recipients who underwent liver biopsy after DSA screening. Liver fibrosis was scored based on the METAVIR fibrosis staging. Patients were divided into 2 groups based on histological findings, and clinical characteristics among patients with liver fibrosis were assessed. Of 18 patients, 7 were included in the fibrosis group. No significant between-group differences were found regarding peritransplant characteristics, including age, sex, primary disease, ABO incompatibility, and immunosuppressive regimen. Episodes of acute rejection and non-adherence to immunosuppressive drugs were comparable between both groups. The MFI for anti-DR DSA and positive rate were significantly higher in the fibrosis group (1655 vs 216; P =.019, 86% vs 27%; P =.012, respectively). MFI for anti-DQ DSA was higher in the fibrosis group, but non-significantly (2052 vs 384; P =.46). Post-transplant anti-DR DSA is associated with graft fibrosis during long-term follow-up. This finding seems useful for the implementation of valid histological examinations of liver grafts for patients with higher MFI, especially for anti-DR DSA, after pediatric LT.
AB - The aim of this study was to evaluate the significance of post-transplant DSA as a predictor of liver fibrosis during long-term follow-up after pediatric LT. We evaluated the histological findings in 18 LT recipients who underwent liver biopsy after DSA screening. Liver fibrosis was scored based on the METAVIR fibrosis staging. Patients were divided into 2 groups based on histological findings, and clinical characteristics among patients with liver fibrosis were assessed. Of 18 patients, 7 were included in the fibrosis group. No significant between-group differences were found regarding peritransplant characteristics, including age, sex, primary disease, ABO incompatibility, and immunosuppressive regimen. Episodes of acute rejection and non-adherence to immunosuppressive drugs were comparable between both groups. The MFI for anti-DR DSA and positive rate were significantly higher in the fibrosis group (1655 vs 216; P =.019, 86% vs 27%; P =.012, respectively). MFI for anti-DQ DSA was higher in the fibrosis group, but non-significantly (2052 vs 384; P =.46). Post-transplant anti-DR DSA is associated with graft fibrosis during long-term follow-up. This finding seems useful for the implementation of valid histological examinations of liver grafts for patients with higher MFI, especially for anti-DR DSA, after pediatric LT.
KW - HLA-DR
KW - liver fibrosis
KW - liver transplantation
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U2 - 10.1111/petr.13169
DO - 10.1111/petr.13169
M3 - Article
C2 - 29542229
AN - SCOPUS:85043689880
SN - 1397-3142
VL - 22
JO - Pediatric Transplantation
JF - Pediatric Transplantation
IS - 3
M1 - e13169
ER -