HLA, Non-HLA Antibodies, and Eplet Mismatches in Pediatric Liver Transplantation: Observations From a Small, Single-Center Cohort.
Adolescent
Age Factors
Child
Child, Preschool
Connecticut
Female
Graft Rejection
/ immunology
Graft Survival
/ drug effects
HLA Antigens
/ immunology
Histocompatibility
Histocompatibility Testing
Humans
Immunosuppressive Agents
/ therapeutic use
Infant
Isoantibodies
/ immunology
Liver Transplantation
/ adverse effects
Male
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Young Adult
Journal
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
ISSN: 2146-8427
Titre abrégé: Exp Clin Transplant
Pays: Turkey
ID NLM: 101207333
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
entrez:
20
2
2019
pubmed:
20
2
2019
medline:
25
6
2019
Statut:
ppublish
Résumé
To identify the risk of developing acute rejection, allograft fibrosis, and antibody-mediated rejection, a retrospective review of pediatric patients who underwent liver transplant between July 31, 1998 and February 29, 2016 and had donor-specific antibodies measured at time of liver biopsy was undertaken. HLAMatchmaker Software (http://www.hlamatchmaker.net) was used to define epitope mismatches between donors and recipients and to predict de novo donor-specific antibody risk. Epitope mismatches were evaluated for their immunogenicity. In our group of 42 recipients, 20 (48%) had donor-specific antibodies. Having an antibody against HLA-DQB1*02 was associated with acute rejection (66.6% vs 36%; P = .024). We found that DQ epitope mismatch load was greater in recipients with class II donor-specific antibodies (9.7 vs 3.6; P = .001). HLA-DQ (7.4 vs 3.6; P = .04) and HLA-DR (8.8 vs 3.8; P = .04) epitope mismatch loads were higher in recipients with DQ + DR donor-specific antibodies. A high portal fibrosis score was associated with higher mismatch load at the DQ locus (P = .005) and DQ + DR loci (P = .03). Having > 5 or > 6 epitope mismatch loads at the DQ locus identified a threshold above which development of DQ donor-specific antibodies would occur (area under the curve = 0.878). Mismatches for eplet 4Q, 45GE, 52PQ, and 52PL, thought to be immunodominant epitopes, were observed for several recipients. Knowledge of epitope mismatches between recipients and donors may aid transplant physicians in devising immunosuppression strategies.
Identifiants
pubmed: 30777518
doi: 10.6002/ect.MESOT2018.L30
doi:
Substances chimiques
HLA Antigens
0
Immunosuppressive Agents
0
Isoantibodies
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM