The Significance of Screening for HLA Antibodies in the Long-Term Follow-up of Pediatric Liver Transplant Recipients.
BACKGROUND
Post-transplant donor-specific anti-HLA antibodies (DSA) reportedly have detrimental effects on the outcomes of organ transplantation. However, the prevalence of post-transplant DSA in the long term after pediatric liver transplantation remains unclear, and the significance of post-transplant DSA is unknown. The aim of this cross-sectional study was to determine the prevalence of and characteristics of patients with post-transplant DSA.


METHODS
Of the 84 pediatric liver transplant recipients who were followed up in the outpatient department of our institution, 34 patients with available HLA typing data were included after they or their parent(s) provided informed consent for DSA evaluations. Luminex single-antigen bead assays were performed, and a mean fluorescence intensity of ≥1000 was used as the cut-off for a positive reaction.


RESULTS
No class I DSA were detected, whereas class II DSA were detected in 11 patients (32%). There were no differences in age at transplantation, immunosuppressive drugs, or follow-up period between the DSA-positive and DSA-negative patients. The rate of positive pre-transplant complement-dependent cytotoxicity crossmatch was higher with class II DSA than without, although the difference was not statistically significant.


CONCLUSIONS
The utility of screening for class I DSA was insignificant in the long-term follow-up of pediatric liver transplant recipients. The prevalence of class II DSA was relatively high; therefore, screening for class II DSA might be justified, although a follow-up survey of the association between post-transplant class II DSA and the long-term clinical course needs to be conducted.
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan. Electronic address: tsu7ka5so8mi@med.tohoku.ac.jp.
K
K
Tokodai
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
N
N
Kawagishi
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
S
S
Miyagi
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
C
C
Nakanishi
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
Y
Y
Hara
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
A
A
Fujio
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
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T
Kashiwadate
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
K
K
Maida
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
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H
Goto
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
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T
Kamei
Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
N
N
Ohuchi
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000077552:Basiliximab; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007518:Isoantibodies / Q000276:immunology*; D016031:Liver Transplantation; D008297:Male; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D065095:Calcineurin Inhibitors; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D007518:Isoantibodies; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab