Influence of donor/recipient HLA-matching on outcome and recurrence of hepatitis C after liver transplantation.
The aim of this study was to analyze the effect of human leukocyte antigen (HLA) matching on outcome, severity of recurrent hepatitis C and risk of rejection in hepatitis C positive patients after liver transplantation (LT). In a retrospective analysis, 165 liver transplants in patients positive for hepatitis C virus (HCV) with complete donor/recipient HLA typing were reviewed for recurrence of HCV and outcome. Follow-up ranged from 1 to 158 months (median, 74.5 months). Immunosuppression consisted of either cyclosporine-A- or tacrolimus-based quadruple induction therapy including or an interleukin 2-receptor antagonist. Protocol liver biopsies were performed after 1, 3, 5, 7, and 10 years and staged according to the Scheuer scoring system. The overall 1-, 5-, and 10-year graft survival figures were 81.8%, 69.11 and 62%, respectively. There was no correlation in the study population between number of HLA mismatches and graft survival. The number of rejection episodes increased significantly in patients with more HLA mismatches (P < 0.05). In contrast to this, the fibrosis progression was significantly faster in patients with 0-5 HLA mismatches compared to patients with a complete HLA mismatch. In conclusion, HLA matching did not influence graft survival in patients after LT for end-stage HCV infection, however, despite less rejection episodes, the fibrosis progression increased in patients with less HLA mismatches within the first year after LT.
Langrehr
Jan Michael
JM
Department of Surgery, Charité, Campus Virchow-Clinic, Humboldt University, Berlin, Germany. jan.langrehr@charite.de
Puhl
Gero
G
Bahra
Marcus
M
Schmeding
Maximilian
M
Spinelli
Antonino
A
Berg
Thomas
T
Schönemann
Constanze
C
Krenn
Veit
V
Neuhaus
Peter
P
Neumann
Ulf Peter
UP
D001926:Brain Death; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006526:Hepatitis C / Q000601:surgery*; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D015994:Incidence; D016031:Liver Transplantation / Q000276:immunology* / Q000401:mortality; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors; D017211:Treatment Failure; D016896:Treatment Outcome
D006680:HLA Antigens