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.
Department of Surgery, Charité, Campus Virchow-Clinic, Humboldt University, Berlin, Germany. jan.langrehr@charite.de
Jan Michael
JM
Langrehr
Gero
G
Puhl
Marcus
M
Bahra
Maximilian
M
Schmeding
Antonino
A
Spinelli
Thomas
T
Berg
Constanze
C
Schönemann
Veit
V
Krenn
Peter
P
Neuhaus
Ulf Peter
UP
Neumann
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