Session Time: 2:30pm-4:00pm
Presentation Time: 2:54pm-3:06pm
Background: Studies in heart, lung, kidney, & liver transplantation (LT) indicate an increased negative impact of antibodies (Ab) to HLA on allograft outcome.
Aim: To describe the frequency & timing of anti-HLA donor specific antibody (DSA) appearance following pediatric LT & the association between the presence of anti-HLA DSA & T-cell mediated rejection (ACR), viral infection, autoAb, & number of HLA antigen (Ag) mismatches.
Methods: Patients followed at our center from 7/31/98-2/29/16 were included (n=63). Anti-HLA DSA was screened in 42 LT recipients. DSA MFI >1000 was considered positive & evaluated retrospectively for ACR.
|DSA Class II: Yes||DSA Class II: No||p value|
|Any enzymes elevated||Yes||14 (63.63 %)||16 (80 %)||0.39|
|No||8 (36.36 %)||4 (20 %)|
|EBV||Yes||5 (27.78 %)||3 (21.43 %)||1.00|
|No||13 (72.22 %)||11 (78.57 %)|
|ACR on liver pathology||Yes||12 (63.16 %)||4 (26.67 %)||0.034|
|No||7 (36.84 %)||11 (73.33 %)|
|Any autoAb present||Yes||5 (31.25 %)||3 (25 %)||1.00|
|No||11 (68.75 %)||9 (75%)|
Rejection episodes coincided with DSA detection. Recipients with DQ Ag mismatches were less likely to have anti-smooth muscle Ab (4.76% vs. 75%; p=0.007). DSA appeared relatively early at 6-12 months post transplant DQ Ag mismatch was not significantly associated with Class II DSA or ACR.
Conclusion: Ab-mediated mechanisms targeting HLA Ag may trigger immune responses like ACR. DQ Ag mismatch is not significantly correlated with ACR or de novo autoimmune hepatitis.
CITATION INFORMATION: Antala S, Bow L, Morotti R, Gan G, Yanhong D, Ekong U, Emre S. Predicting Immunologic Risk for Acute Rejection in Pediatric Liver Transplantation. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Antala S, Bow L, Morotti R, Gan G, Yanhong D, Ekong U, Emre S. Predicting Immunologic Risk for Acute Rejection in Pediatric Liver Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/predicting-immunologic-risk-for-acute-rejection-in-pediatric-liver-transplantation/. Accessed August 6, 2020.
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