title: Impact of donor-recipient genetic relationship on outcome of living donor liver transplantation.
abstract: Living donor liver transplantation (LDLT) is a valuable option for expanding the donor pool, especially in localities where deceased organ harvesting is not allowed. In addition, rejection rates were found to be lower in LDLT, which is attributed to the fact that LDLT is usually performed between relatives. However, the impact of genetic relation on the outcome of LDLT has not been studied. In this study, we examined the difference in rejection rates between LDLT from genetically related (GR) donors and genetically unrelated (GUR) donors. All cases that underwent LDLT during the period from May 2004 until May 2014 were included in the study. The study group was divided into 2 groups: LDLT from GR donors and LDLT from GUR donors. A total of 308 patients were included in the study: 212 from GR donors and 96 from GUR donors. Human leukocyte antigen (HLA) typing was not included in the workup for matching donors and recipients. GUR donors were wives (36; 11.7%), sons-in-law (7; 2.3%), brothers-in-law (12; 3.9%), sisters-in-law (1; 0.3%), and unrelated (38; 12.3%). The incidence of acute rejection in the GR group was 17.4% and 26.3% in the GUR group (P value = 0.07). However, there was a significant difference in the incidence of chronic rejection (CR) between the 2 groups: 7% in GR group and 14.7% in the GUR group (P value = 0.03). In terms of overall survival, there was no significant difference between both groups. LDLT from the GUR donors is not associated with a higher incidence of acute cellular rejection. However, CR was significantly lower when grafts were procured from GR donors. HLA matching may be recommended before LDLT from GUR donors. Liver Transplantation 23:43-49 2017 AASLD.
authors: Liver Transplantation Unit, Gastroenterology Surgical Center, Mansoura University, Mansoura City, Egypt.
authors: Mahmoud Abdelwahab
authors: 0000-0001-7958-4202
authors: MA
authors: Ali
authors: Liver Transplantation Unit, Gastroenterology Surgical Center, Mansoura University, Mansoura City, Egypt.
authors: Mohamed Morsi
authors: MM
authors: Elshobari
authors: Liver Transplantation Unit, Gastroenterology Surgical Center, Mansoura University, Mansoura City, Egypt.
authors: Tarek
authors: T
authors: Salah
authors: Anesthesia and Intensive Care Department, Mansoura University, Mansoura City, Egypt.
authors: Al-Refaey
authors: AR
authors: Kandeel
authors: Liver Transplantation Unit, Gastroenterology Surgical Center, Mansoura University, Mansoura City, Egypt.
authors: Ahmad Mohammad
authors: AM
authors: Sultan
authors: Liver Transplantation Unit, Gastroenterology Surgical Center, Mansoura University, Mansoura City, Egypt.
authors: Ahmad Nabieh
authors: AN
authors: Elghawalby
authors: Liver Transplantation Unit, Gastroenterology Surgical Center, Mansoura University, Mansoura City, Egypt.
authors: Ahmed
authors: A
authors: Shehta
authors: Anesthesia and Intensive Care Department, Mansoura University, Mansoura City, Egypt.
authors: Usama
authors: U
authors: Elsayed
authors: Liver Transplantation Unit, Gastroenterology Surgical Center, Mansoura University, Mansoura City, Egypt.
authors: Omar
authors: O
authors: Fathy
authors: Anesthesia and Intensive Care Department, Mansoura University, Mansoura City, Egypt.
authors: Amr
authors: 0000-0001-6607-7877
authors: A
authors: Yassen
authors: Liver Transplantation Unit, Gastroenterology Surgical Center, Mansoura University, Mansoura City, Egypt.
authors: Mohamed Abdel
authors: MA
authors: Wahab
mesh_terms: D000328:Adult; D058625:End Stage Liver Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000235:genetics* / Q000276:immunology; D006680:HLA Antigens / Q000032:analysis; D016174:Hepacivirus / Q000302:isolation & purification; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period / Q000401:mortality; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020858:Tissue and Organ Harvesting / Q000331:legislation & jurisprudence / Q000379:methods*; D066027:Transplant Recipients; D016896:Treatment Outcome; D061349:Unrelated Donors
chemical_list: D006680:HLA Antigens