The Effect of Preformed and De Novo Donor-Specific Antibodies (DSA) in Acute Rejection (AR) After Liver Transplantation (LTX)
1Hepatobiliary Surgery and Transplantation, University Medical Centre, Hamburg, Germany
2HLA-Laboratory, University Medical Centre, Hamburg, Germany.
Meeting: 2015 American Transplant Congress
Abstract number: A201
Keywords: HLA antibodies, Liver transplantation, Rejection
Session Information
Session Name: Poster Session A: Liver: Immunosuppression and Rejection
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
BACKGROUND: The role of preformed and den novo formed DSA in LTX is not fully revealed. The aim of our study was to determine if there is a correlation between HLA antibodies (Ab) or DSA pre transplant and one year post LTX with AR in the first year after transplantation.
METHODS: Out of 368 adult LTX performed at our centre between 2008 – 2013, serum samples pre and one yr post LTX were available of 110 patients. Serum was retrospectively analyzed with Luminex Single Antigen Assay for HLA antibodies class I and class II. AR was defined as biopsy proven with a minimal Banff-score of 3/9.
RESULTS:
There was no correlation with HLA Ab or DSA pre transplant and AR within the first year post LTX. Class II DSA were rare (10% of patients, Tab. 1). In patients with AR during the first year post LTX significantly more HLA Ab were detected one year post transplantation compared to patients without AR. While DSA class I decreased, de novo class II Ab were frequent, especially in patients with AR (32%, Tab. 2).
| all n=110 | AR n=38 | no AR n=72 | p-value | |
| HLA | 71 (65%) | 26 (68%) | 45 (63%) | 0.681 |
| HLA class I | 61 (55%) | 22 (58%) | 39 (54%) | 0.871 |
| HLA class II | 48 (44%) | 15 (39%) | 33 (46%) | 0.378 |
| DSA | 29 (26%) | 11 (29%) | 18 (25%) | 0.740 |
| DSA class I | 23 (21%) | 9 (24%) | 14 (19%) | 0.674 |
| DSA class II | 11 (10%) | 4 (4%) | 7 (6%) | 0.907 |
| all n=110 | AR n=38 | no AR n=72 | p-value | |
| HLA | 81 (74%) | 34 (89%) | 47 (65%) | 0.010 |
| HLA class I | 61 (55%) | 27 (71%) | 33 (46%) | 0.024 |
| HLA class II | 56 (51%) | 24 (63%) | 32 (44%) | 0.083 |
| DSA | 32 (29%) | 15 (40%) | 17 (24%) | 0.065 |
| DSA class I | 12 (11%) | 5 (13%) | 7 (10%) | 0.567 |
| DSA class II | 24 (22%) | 12 (32%) | 12 (17%) | 0.059 |
CONCLUSIONS: While preformed HLA Ab or DSA seem not to be a risk factor for AR, there is a significant correlation between the presence of HLA Ab one year after LTX and AR (p=0.010). Class I DSA seem to be adsorbed by the graft while de novo Class II DSA were more frequently detected in patients sera after AR. This arises the question, if anti-HLA Ab in LTX might be rather the result but not the cause of AR. Long term follow up of these patients will clarify the role of HLA Ab for chronic rejection in LTX.
To cite this abstract in AMA style:
Koch M, Runnebaum M, Goebel M, Thude H, Sterneck M, Marget M, Nashan B. The Effect of Preformed and De Novo Donor-Specific Antibodies (DSA) in Acute Rejection (AR) After Liver Transplantation (LTX) [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-effect-of-preformed-and-de-novo-donor-specific-antibodies-dsa-in-acute-rejection-ar-after-liver-transplantation-ltx/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress