title: De Novo Donor-Specific Anti-Human Leukocyte Antigen Antibody Detection in Long-Term Adult Liver Transplantation.
abstract: Information about the consequences of de novo donor-specific anti-human leukocyte antigen (DSA) antibody development in the long term after adult liver transplantation (LT) is scarce. We conducted a cross-sectional study in LT patients with a follow-up of at least 6 years.
  
  
  
  A total of 28 adult LT patients were included, with a median follow-up of 77 months (range, 63 to 96) and without preformed anti- human leukocyte antigen (HLA) antibodies prior to LT. The anti-HLA identification was performed with LABScreen Single Antigen, whereas the ability to fix the complement was demonstrated with C1q test (One Lambda). In both assays, a value >3.500 mean fluorescence intensity (MFI) was considered positive. The anti-HLA antibody specificities were compared with donor HLA antigens to confirm them as DSA. Hepatic fibrosis was assessed by transient elastography.
  
  
  
  In 5 patients (17.8%), de novo DSA were detected, all them against DQ locus. In all of these cases (100%) the complement fixation was confirmed by C1q binding. The grade of hepatic fibrosis in de novo DSA patients was significantly higher compared with No-DSA patients (13.2 ± 9.2 KPa vs 7.3 ± 3.7 KPa; P = .02). It is noteworthy that in both groups of patients the levels of liver function tests (LFT) at the time of the study were normal or near the normal range with no difference between patients with or without de novo DSA.
  
  
  
  Our preliminary results are consistent with those previously demonstrated in pediatric LT, where de novo DSA production and humoral response could contribute to the liver fibrosis observed in the long term after LT in pediatric patients with normal or near-normal LFT.
authors.affiliation: Immunology Unit, University Hospital Marqués de Valdecilla, Santander, Spain; Instituto de Investigación Marqués de Valdecilla, Santander, Spain.
authors.forename: D
authors.initials: D
authors.lastname: San Segundo
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Alonso
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Ruiz
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Hematology Unit, University Hospital Marqués de Valdecilla, Santander, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Romon
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain.
authors.forename: M T
authors.initials: MT
authors.lastname: Arias-Loste
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Cuadrado
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Puente
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Casafont
authors.affiliation: Immunology Unit, University Hospital Marqués de Valdecilla, Santander, Spain; Instituto de Investigación Marqués de Valdecilla, Santander, Spain.
authors.forename: M
authors.initials: M
authors.lastname: López-Hoyos
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Crespo
authors.affiliation: Instituto de Investigación Marqués de Valdecilla, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital Marqués de Valdecilla, Faculty of Medicine, Santander, Spain. Electronic address: digfge@humv.es.
authors.forename: E
authors.initials: E
authors.lastname: Fábrega
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D003430:Cross-Sectional Studies; D058625:End Stage Liver Disease / Q000276:immunology / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007518:Isoantibodies / Q000276:immunology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014019:Tissue Donors
chemical_list: D000888:Antibodies, Anti-Idiotypic; D006680:HLA Antigens; D007518:Isoantibodies