Impact of donor-specific antibodies on results of liver transplantation

Jacqueline G. O'Leary, Goran B. Klintmalm

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations

Abstract

Purpose of review: To critically examine the recent literature evaluating the importance of HLA donor-specific antibody (DSA) impact on liver transplant and simultaneous liver-kidney transplant (SLKT) outcomes. Recent findings: Many preformed DSAs, especially of low mean fluorescence intensity (MFI), are absorbed by the liver at transplant. However, patients with post-liver transplant DSA, especially of higher MFI, are at increased risk of acute and chronic rejection. C4d staining, when positive, may be helpful but lacks sensitivity especially in formalin tissue. SLKT recipients may need close follow-up when class II DSA is found, as the liver protects the kidney from hyperacute rejection, but can still cause early renal antibody-mediated rejection, liver allograft rejection, and impair patient, liver allograft, and renal allograft survival. Summary: Some DSAs are relevant in liver transplant and can lead to acute and chronic allograft rejection. However, before clinical practice patterns can change we must create unified diagnostic criteria, define the pathologic potential of different DSAs, and improve the specificity of current testing.

Original languageEnglish (US)
Pages (from-to)279-284
Number of pages6
JournalCurrent Opinion in Organ Transplantation
Volume18
Issue number3
DOIs
StatePublished - Jun 1 2013

Keywords

  • Donor-specific antibodies
  • Liver transplantation
  • Outcomes
  • Simultaneous liver-kidney transplant

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation

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