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Histocompatibility and liver transplantation.

Publication ,  Journal Article
Knechtle, SJ; Kalayolu, M; D'Alessandro, AM; Mason, B; Pirsch, JD; Sollinger, HW; Steen, DC; Belzer, FO
Published in: Surgery
October 1993

BACKGROUND: The role of histocompatibility between donor and recipient in liver transplant rejection is unclear because of a paucity of data. The influence of human leukocyte antigen (HLA) type on immunologic graft loss was examined for primary liver transplantations performed at this center. METHODS: Immunologic graft loss included patient death or retransplantation as a result of rejection or impending graft loss caused by either late hepatic artery thrombosis or severe, unremitting rejection requiring FK 506 rescue therapy. HLA A, B, and DR matching was available on 205 donor-recipient combinations, and an additional 31 patients had A and B matching only. RESULTS: A mismatch of class I antigens (HLA A and B) was predictive of immunologic graft loss (p = 0.018). DR mismatch did not correlate with graft loss. When the A and B loci were analyzed separately, an A mismatch correlated significantly with immunologic graft loss (p = 0.02), in contrast to a B mismatch (p = 0.17). Better matching significantly improved patient survival (p = 0.02) and overall graft survival (p = 0.009). CONCLUSIONS: The beneficial effect of HLA class I antigen compatibility on liver transplantation outcome is in contrast to pancreatic and kidney transplantation in which class II antigen matching but not class I matching is beneficial. Immunologic mechanisms of hepatic allograft rejection may differ from those involved in kidney transplant rejection.

Duke Scholars

Published In

Surgery

ISSN

0039-6060

Publication Date

October 1993

Volume

114

Issue

4

Start / End Page

667 / 671

Location

United States

Related Subject Headings

  • Surgery
  • Liver Transplantation
  • Humans
  • Histocompatibility Testing
  • Histocompatibility Antigens Class II
  • Histocompatibility Antigens Class I
  • Histocompatibility
  • HLA Antigens
  • Graft Survival
  • Graft Rejection
 

Citation

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Knechtle, S. J., Kalayolu, M., D’Alessandro, A. M., Mason, B., Pirsch, J. D., Sollinger, H. W., … Belzer, F. O. (1993). Histocompatibility and liver transplantation. Surgery, 114(4), 667–671.
Knechtle, S. J., M. Kalayolu, A. M. D’Alessandro, B. Mason, J. D. Pirsch, H. W. Sollinger, D. C. Steen, and F. O. Belzer. “Histocompatibility and liver transplantation.Surgery 114, no. 4 (October 1993): 667–71.
Knechtle SJ, Kalayolu M, D’Alessandro AM, Mason B, Pirsch JD, Sollinger HW, et al. Histocompatibility and liver transplantation. Surgery. 1993 Oct;114(4):667–71.
Knechtle, S. J., et al. “Histocompatibility and liver transplantation.Surgery, vol. 114, no. 4, Oct. 1993, pp. 667–71.
Knechtle SJ, Kalayolu M, D’Alessandro AM, Mason B, Pirsch JD, Sollinger HW, Steen DC, Belzer FO. Histocompatibility and liver transplantation. Surgery. 1993 Oct;114(4):667–671.
Journal cover image

Published In

Surgery

ISSN

0039-6060

Publication Date

October 1993

Volume

114

Issue

4

Start / End Page

667 / 671

Location

United States

Related Subject Headings

  • Surgery
  • Liver Transplantation
  • Humans
  • Histocompatibility Testing
  • Histocompatibility Antigens Class II
  • Histocompatibility Antigens Class I
  • Histocompatibility
  • HLA Antigens
  • Graft Survival
  • Graft Rejection