Relevance of HLA compatibility in living donor liver transplantation: the double-edged sword associated with the patient outcome.
HLA compatibility in living donor liver transplantation (LDLT) seems relevant to the acceptability of graft livers because LDLT recipients often share most or some part of HLAs with the respective donors. This study retrospectively investigated whether HLA compatibility affected the outcome of LDLT. Three hundred ninety LDLTs were performed in this hospital, and 346 pairs of HLAs (HLA-A, B, DR) were retrieved from the medical record between October 1996 and March 2011. The dates of the deaths were censored when a recipient apparently died of or was retransplanted by other causes than graft failure because of host-versus-graft (HVG) response to purely analyze the outcomes of LDLT in view of HVG response. The relationship between HLA compatibility and graft-versus-host disease (GVHD) was also analyzed. No recipients with recipient-against-donor HLA mismatch (R→D MM) 0 experienced graft failure by HVG response. On the other hand, three of five recipients with "R→D MM 0" together with "donor-against-recipient MM 3" died of fatal GVHD. HLA compatibility in LDLT not only affected the long-term acceptance of graft livers but also the risk of fatal GVHD.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. huchi@surg2.med.kyushu-u.ac.jp
Hideaki
H
Uchiyama
Hiroto
H
Kayashima
Rumi
R
Matono
Ken
K
Shirabe
Tomoharu
T
Yoshizumi
Toru
T
Ikegami
Yuji
Y
Soejima
Toshiharu
T
Matsuura
Tomoaki
T
Taguchi
Yoshihiko
Y
Maehara
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology*; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality*; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000276:immunology / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult
D006680:HLA Antigens