Katharina Willuweit1,2, Andreas Heinold3, Jassin Rashidi-Alavijeh1,2, Falko M Heinemann3, Peter A Horn3, Andreas Paul2, Guido Gerken1, Kerstin Herzer1,2. 1. Department of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany. 2. Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany. 3. Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany.
Abstract
BACKGROUND: Donor-specific antibodies (DSAs) are an important cause of complications after solid organ transplant. Risk factors and, thus, strategies for preventing DSA development are not well defined. METHODS: The DSA status of 400 patients who underwent liver transplant (LT) at the outpatient clinic of the University Hospital Essen was determined. Human leukocyte antigen (HLA) antibodies were detected by single-antigen bead technology. The strength of DSAs was reported as mean fluorescence intensity. RESULTS: Detectable DSAs were found in 74 (18.5%) patients and significantly more often in patients who underwent LT for autoimmune liver disease than for all other indications (29.3%; P=.022), but significantly less often found in patients who underwent LT for hepatocellular carcinoma (7.6%, P=.005). The incidence of DSAs increased with time after LT, and the risk was generally higher for female patients. The frequency of DSA detection was significantly lower (10.6%) for patients receiving immunosuppressive treatment with mammalian target of rapamycin (mTOR) inhibitors than for those receiving other regimens (20.5%; P=.025). CONCLUSION: Autoimmune liver diseases, female sex, and time of more than 8 years since LT predispose patients to the development of DSAs. Immunosuppression with the mTOR inhibitor everolimus protects against DSA development after liver transplant.
BACKGROUND:Donor-specific antibodies (DSAs) are an important cause of complications after solid organ transplant. Risk factors and, thus, strategies for preventing DSA development are not well defined. METHODS: The DSA status of 400 patients who underwent liver transplant (LT) at the outpatient clinic of the University Hospital Essen was determined. Human leukocyte antigen (HLA) antibodies were detected by single-antigen bead technology. The strength of DSAs was reported as mean fluorescence intensity. RESULTS: Detectable DSAs were found in 74 (18.5%) patients and significantly more often in patients who underwent LT for autoimmune liver disease than for all other indications (29.3%; P=.022), but significantly less often found in patients who underwent LT for hepatocellular carcinoma (7.6%, P=.005). The incidence of DSAs increased with time after LT, and the risk was generally higher for female patients. The frequency of DSA detection was significantly lower (10.6%) for patients receiving immunosuppressive treatment with mammalian target of rapamycin (mTOR) inhibitors than for those receiving other regimens (20.5%; P=.025). CONCLUSION:Autoimmune liver diseases, female sex, and time of more than 8 years since LT predispose patients to the development of DSAs. Immunosuppression with the mTOR inhibitor everolimus protects against DSA development after liver transplant.
Authors: Anne Höfer; Danny Jonigk; Björn Hartleben; Murielle Verboom; Michael Hallensleben; Michael P Manns; Elmar Jaeckel; Richard Taubert Journal: Sci Rep Date: 2020-08-28 Impact factor: 4.379
Authors: Safak Gül-Klein; Henriette Hegermann; Robert Röhle; Moritz Schmelzle; Frank Tacke; Wenzel Schöning; Robert Öllinger; Tomasz Dziodzio; Patrick Maier; Julius M Plewe; David Horst; Igor Maximilian Sauer; Johann Pratschke; Nils Lachmann; Dennis Eurich Journal: J Inflamm Res Date: 2021-06-23