title: Influence of human leukocyte antigen mismatching on rejection development and allograft survival in liver transplantation: is the relevance of HLA-A locus matching being underestimated?
abstract: The influence of HLA matching on liver transplant is still controversial, as studies have failed to demonstrate an adverse effect of HLA mismatching on transplant outcome. We examined the effect of HLA mismatching on transplant outcome in a series of 342 consecutive liver transplants (224 finally analyzed). HLA typing was performed by serological and molecular methods. HLA-A matching was associated with an increased chronic rejection incidence (P=0.04). Indeed, HLA-A match also demonstrated a significant impact on allograft survival (P=0.03), confirming previous observation concerning to rejection, as complete HLA-A mismatching favored a better liver transplant outcome. Analysis of HLA-A+B+DR matching also demonstrated a significant impact on graft survival (P<0.05). Multivariate Cox regression analysis confirmed the effect of HLA-A and DPB1 matching as independent risk factors for graft loss. Another independent factor was a positive pre-transplant crossmatch. In conclusion, liver transplant outcome has not been found to be improved by HLA matching, however a poorer HLA compatibility favored a better graft survival and decreased rejection incidence, with a special relevance for HLA-A matching.
authors: Immunology Service, University Hospital Virgen Arrixaca, Murcia 30120, Spain. manuel.muro@carm.es
authors: Manuel
authors: M
authors: Muro
authors: María R
authors: MR
authors: López-Álvarez
authors: Jose A
authors: JA
authors: Campillo
authors: Luis
authors: L
authors: Marin
authors: María R
authors: MR
authors: Moya-Quiles
authors: Jose M
authors: JM
authors: Bolarín
authors: Carmen
authors: C
authors: Botella
authors: Gema
authors: G
authors: Salgado
authors: Pedro
authors: P
authors: Martínez
authors: Francisco
authors: F
authors: Sánchez-Bueno
authors: Ruth
authors: R
authors: López-Hernández
authors: Francisco
authors: F
authors: Boix
authors: Alexandre
authors: A
authors: Bosch
authors: Helios
authors: H
authors: Martínez
authors: Jesús M
authors: JM
authors: de la Peña-Moral
authors: Noelia
authors: N
authors: Pérez
authors: Ricardo
authors: R
authors: Robles
authors: Ana M
authors: AM
authors: García-Alonso
authors: Alfredo
authors: A
authors: Minguela
authors: Manuel
authors: M
authors: Miras
authors: María R
authors: MR
authors: Alvarez-López
mesh_terms: D000328:Adult; D005260:Female; D056426:Genetic Loci / Q000276:immunology; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology*; D015234:HLA-A Antigens / Q000276:immunology*; D015235:HLA-B Antigens / Q000276:immunology; D006684:HLA-DR Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous
chemical_list: D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens