Impact of HLA-compatibilities in patients undergoing liver transplantation for HBV-cirrhosis.
Liver transplantation (OLT) for end-stage chronic hepatitis-B-virus (HBV) infection is frequently complicated by HBV recurrence. In the present study we investigated whether human leucocyte antigen (HLA)-matching influences the outcome after OLT. In a retrospective analysis we reviewed 84 recipients of liver transplants for end-stage HBV-cirrhosis and complete HLA-typing for outcome after OLT. Follow-up ranges from 1 to 110 months (median = 55.6 months). Immunosuppression consisted of Cyclosporin A (CsA)-based quadruple induction therapy or Tacrolimus-based induction protocols. Immunoprophylaxis with hepatitis B immunoglobulin was started at OLT and continued long-term. Actuarial 1- and 5-yr graft survival figures were 90.5 and 80.4%, respectively. Hepatitis-B recurrence was responsible for 15 of 20 (75%) graft failures. We observed a significantly improved graft survival in patients with more HLA-A, -B compatibilities (p = 0.02), whereas the degree of HLA-DR compatibilities did not influence the outcome. The occurrence of HBV-reinfection was significantly lower in HLA-A, -B matched grafts (p < 0.05). Additionally, graft survival was prolonged in patients with HBV-reinfection and 1 or 2 HLA-B compatibilities when compared with patients with HBV-reinfection and a complete HLA-B mismatch (p = 0.02). In conclusion, this retrospective analysis shows that more HLA-A, -B compatibilities seems to be associated with an improved graft survival in patients after OLT for end-stage HBV infection.
Neumann
Ulf P
UP
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité, Virchow-Klinikum, Humboldt Universität zu Berlin, Germany. ulf.neumann@charite.de
Langrehr
Jan M
JM
Naumann
Uta
U
Lang
Martina
M
Rayes
Nada
N
Steinmüller
Thomas
T
Radtke
Cornelia
C
Neuhaus
Peter
P
D006085:Graft Survival; D015234:HLA-A Antigens / Q000032:analysis; D015235:HLA-B Antigens / Q000032:analysis; D006684:HLA-DR Antigens / Q000032:analysis; D019694:Hepatitis B, Chronic / Q000517:prevention & control / Q000601:surgery*; D006650:Histocompatibility Testing; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000276:immunology* / Q000401:mortality; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate
D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin