Introduction: This study aimed to investigate the acute rejection rate and graft function after liver transplantation according to pre-transplantation donor specific antibody (DSA) status and changing pattern of DSA after liver transplantation.

Patients and methods: This study was prospectively designed observational study from March 2011 to October 2013. Forty patients were enrolled in this study. Singe antigen bead assays were performed to detect DSA all patients at pre-transplantation, post-transplant-7, 14, 21, 3rd month and 6th month.

Results: There were four patients (10%) with acute rejection and eleven patients (27.5%) with biliary complication. Four patients (10%) were positive on DSA before transplantation and one of them was converted to negative on DSA after transplantation. Three patients who had no DSA before transplantation showed de Novo DSA after liver transplantation. Two of four patients with acute rejection were positive on DSA. One of four patients with acute rejection showed pre-transplant DSA and de Novo DSAs were detected in another one acute rejection patient. Seven patients of eleven patients with biliary complication showed no DSA and the others demonstrated de Novo DSA after transplantation (p=0.039). Biliary complications occurred in two of three patients with de Novo DSA. Figure showed the change pattern of mean fluorescent intensity (MFI).

Conclusions: De Novo- DSA after transplantation can be associated biliary complication and the patients with high MFI showed more biliary complication. Further study with large sample size and long-term follow-up are needed.

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