TY - JOUR
T1 - Donor-specific anti-HLA antibodies are not associated with nonanastomotic biliary strictures but both are independent risk factors for graft loss after liver transplantation
AU - den Dulk, Anne Claire
AU - Shi, Xiaolei
AU - Verhoeven, Cornelia J.
AU - Dubbeld, Jeroen
AU - Claas, Frans H.J.
AU - Wolterbeek, Ron
AU - Brand-Schaaf, Simone H.
AU - Verspaget, Hein W.
AU - Sarasqueta, Arantza Fariña
AU - van der Laan, Luc J.W.
AU - Metselaar, Herold J.
AU - van Hoek, Bart
AU - Kwekkeboom, Jaap
AU - Roelen, Dave L.
N1 - Funding Information: Funding information Anne Claire den Dulk was supported by a grant from Fund NutsOhra and Xiaolei Shi was supported by a PhD fellowship grant of the China Scholarship Council (File No. 2011623039) The authors would like to thank A. van der Eijk for providing serum samples. Publisher Copyright: © 2017 The Authors. Clinical Transplantation Published by John Wiley & Sons Ltd
PY - 2018/2
Y1 - 2018/2
N2 - Donor-specific alloantibodies (DSA) have been associated with rejection and shorter graft survival after orthotopic liver transplantation (OLT). We examined the role of DSA in nonanastomotic biliary strictures (NAS) after OLT. Patients receiving first OLT who developed NAS (n = 68) and a control group without NAS (n = 83), with pre-OLT and 12 months post-OLT serum samples, were included. DSA were specified using the Luminex single antigen test. Risk factors for NAS and graft survival were analyzed. The presence of preformed DSA was not significantly different between patients with NAS and controls (P =.89). After 12 months, 26.5% of NAS patients and 16.9% of controls had generated de novo DSA (P =.15). Neither de novo class I DSA nor de novo class II DSA were associated with NAS. De novo DSA generally developed after the diagnosis of NAS. Time-dependent regression analysis identified both NAS (aHR 8.05, CI 3.28 – 19.77, P <.01) and de novo class II DSA (aHR 2.84, CI 1.38 – 5.82, P <.01) as independent risk factors for graft loss. Preformed or de novo DSA were not associated with the development of NAS. However, NAS as well as de novo class II DSA were independent risk factors for graft loss after OLT.
AB - Donor-specific alloantibodies (DSA) have been associated with rejection and shorter graft survival after orthotopic liver transplantation (OLT). We examined the role of DSA in nonanastomotic biliary strictures (NAS) after OLT. Patients receiving first OLT who developed NAS (n = 68) and a control group without NAS (n = 83), with pre-OLT and 12 months post-OLT serum samples, were included. DSA were specified using the Luminex single antigen test. Risk factors for NAS and graft survival were analyzed. The presence of preformed DSA was not significantly different between patients with NAS and controls (P =.89). After 12 months, 26.5% of NAS patients and 16.9% of controls had generated de novo DSA (P =.15). Neither de novo class I DSA nor de novo class II DSA were associated with NAS. De novo DSA generally developed after the diagnosis of NAS. Time-dependent regression analysis identified both NAS (aHR 8.05, CI 3.28 – 19.77, P <.01) and de novo class II DSA (aHR 2.84, CI 1.38 – 5.82, P <.01) as independent risk factors for graft loss. Preformed or de novo DSA were not associated with the development of NAS. However, NAS as well as de novo class II DSA were independent risk factors for graft loss after OLT.
KW - HLA-antibody post-transplantation
KW - biliary strictures
KW - complications
KW - donor-specific antibodies
KW - liver transplantation
KW - outcome
UR - http://www.scopus.com/inward/record.url?scp=85038954603&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85038954603&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29193362
U2 - https://doi.org/10.1111/ctr.13163
DO - https://doi.org/10.1111/ctr.13163
M3 - Article
C2 - 29193362
SN - 0902-0063
VL - 32
JO - Clinical transplantation
JF - Clinical transplantation
IS - 2
M1 - e13163
ER -