02 June 2017 : Original article
Effect of Recipient Age at Liver Transplantation on Prevalence of Post-Transplant Donor-Specific HLA Antibody
Kazuaki Tokodai1ABCDEFG*, Shigehito Miyagi1ADE, Chikashi Nakanishi1CDF, Yasuyuki Hara1BCE, Wataru Nakanishi1BCE, Michiaki Unno1DEF, Takashi Kamei1ADEFDOI: 10.12659/AOT.903926
Ann Transplant 2017; 22:333-337
Abstract
BACKGROUND: Post-transplant donor-specific HLA antibodies (DSA) may have a detrimental effect on long-term outcomes of organ transplantation. The aim of this study was to specifically evaluate the effect of recipient age on the prevalence of DSA over a long-term follow-up after living donor liver transplantation (LDLT).
MATERIAL AND METHODS: A retrospective analysis of DSA evaluations was performed in 50 pediatric patients with HLA data available. Patients were divided into 2 groups based on their age at the time of LDLT: younger (Y) group, age <3 years; older (O) group, age ≥3 years. DSA evaluation was performed using Luminex single-antigen bead assays, with a mean fluorescence intensity ≥1000 used as a cut-off for positive results.
RESULTS: There were no between-group differences in terms of sex, ABO incompatibility or acute rejection. Only one of our 50 patients tested positive for class I DSA. Significantly more patients tested positive for HLA-DR DSA in group Y (40.6%) than in group O (11.1%; p=0.02). Recipients <3 years of age at the time of LDLT may be at a higher risk of testing positive for class II DSA.
CONCLUSIONS: These findings can inform the implementation of cost-effective screening of post-transplant DSA in pediatric LDLT recipients.
Keywords: Hospitals, Pediatric, Immunosuppression, Liver Transplantation, Living Donors
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