Antidonor antibody in patients receiving ABO-identical and HLA-mismatched living donor liver transplants: effect on survival.
We retrospectively determined the correlation of results of lymphocyte crossmatch tests by direct complement-dependent cytotoxicity, to the outcomes of 585 consecutive ABO-identical and human leukocyte antigen (HLA)-mismatched living donor liver transplants (LDLTs) (male:female=276:309; median age, 18 years). Crossmatch test results were positive in 14 recipients (2.4%). Patient survival at eight years in the crossmatch-positive group was significantly lower than in the crossmatch-negative group (positive group, 56.3%; negative group, 77.6%; P=0.014). The survival at five years of the crossmatch-positive group was significantly lower than the negative group in both older recipients (>or=18 years of age: positive group, 41.7%; negative group, 76.4%; P=0.0065), and female recipients (positive group, 37.5%; negative group, 81.9%; P=3.3x10). We conclude that antidonor antibodies have adverse effects on the clinical outcome of LDLTs, and that being female and/or older aged (>or=18 years of age) are risk factors for LDLT.
Ashihara
Eishi
E
Department of Blood Transfusion and Cell Therapy, Kyoto, Japan. ash0325@kuhp.kyoto-u.ac.jp
Tsuji
Hiroaki
H
Sakashita
Hiromi
H
Haga
Hironori
H
Yurugi
Kimiko
K
Kimura
Shinya
S
Egawa
Hiroto
H
Manabe
Toshiaki
T
Uemoto
Shinji
S
Maekawa
Taira
T
D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016031:Liver Transplantation / Q000276:immunology* / Q000473:pathology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
D000017:ABO Blood-Group System; D000906:Antibodies; D006680:HLA Antigens