UCLA liver transplantation: analysis of immunological factors affecting outcome.
From 1988 to 1993, UCLA completed 938 first and 1,146 total orthotopic liver transplants (OLT). Race analysis demonstrated a 1-year patient survival of 89% in Blacks (n = 45) versus 80% in Whites (n = 492, p < 0.02), with no significant difference shown between Hispanics (n = 278) and Whites. The 1-year patient survival in Asians was 50% (n = 58, p < 0.02 vs. Whites) even when hepatitis B was excluded (59%, n = 43). The 1-year patient survival of hepatitis B surface antigen positive Asians (n = 15) was only 21% (p < 0.02 vs. all others). OLT patients whose panel reactive antibody (PRA) was < 10% (n = 339) demonstrated no graft or patient survival advantage versus recipients whose PRA was > 10% (n = 71). A positive antidonor flow cytometry crossmatch (> 30 mean channel shifts, n = 76) was associated with a decreased 1-year graft survival (56% vs. 73%, p < 0.05) when compared to flow negative recipients (n = 185). Graft survival for 0 DR mismatches was 74% at 1 year compared with 57% for 1 DR mismatches (p < 0.02) and 59% for 2 DR mismatches (p < 0.02).
Dumont-UCLA Transplant Center, UCLA School of Medicine 90095, USA.
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Dawson
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Imagawa
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Johnson
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Busuttil
D000328:Adult; D000918:Antibody Specificity; D044466:Asian People; D001379:Azathioprine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016572:Cyclosporine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D005434:Flow Cytometry; D006084:Graft Rejection / Q000188:drug therapy / Q000517:prevention & control; D006514:Hepatitis B Surface Antigens; D006630:Hispanic or Latino; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology / Q000401:mortality; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D013256:Steroids / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D016559:Tacrolimus / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D044465:White People
D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine; D001379:Azathioprine; D016559:Tacrolimus