One-way donor-recipient HLA-matching as a risk factor for graft-versus-host disease in living-related liver transplantation.
Although one-way matching between an HLA-homozygous donor and a haploidentical recipient is a recognized risk factor in transfusion-associated graft-versus-host disease (GVHD), its impact in living-related liver transplantation (LRLT) has so far not been investigated. We present a case of fatal acute GVHD in our LRLT program that was attributed to one-way HLA matching between donor and recipient. Although the disappearance of donor cells in peripheral blood was suggested by genetic analysis, severe septicemia led to a fatal outcome. We further reviewed 280 LRLT cases and correlated one-way HLA matching with outcome. A total of 8 out of 280 donors (2.9%) and 11 out of 278 recipients (4.0%) were completely HLA homozygous in our LRLT program. Complete one-way HLA matching linked to GVHD was observed in four cases, including the present case. Although other contributing factors also need to be clarified, one-way HLA matching is a definite risk factor for GVHD in LRLT. We advocate caution before proceeding with one-way HLA donor-recipient combinations.
Department of Transplant Surgery, Kyoto University Faculty of Medicine, Japan.
T
T
Kiuchi
H
H
Harada
H
H
Matsukawa
M
M
Kasahara
Y
Y
Inomata
S
S
Uemoto
K
K
Asonuma
H
H
Egawa
E
E
Maruya
H
H
Saji
K
K
Tanaka
D017809:Fatal Outcome; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D012307:Risk Factors; D014181:Transplantation Immunology
D006680:HLA Antigens