De Novo Donor-Specific Anti–Human Leukocyte Antigen Antibody Detection in Long-Term Adult Liver Transplantation

Segundo, David San; Alonso, Carmen; Ruíz, Pablo; Roman, Iulia Ioana; Arias-Loste, María Teresa; Cuadrado, Antonio; Puente, Ángela; Casafont, F.; López-Hoyos, Marcos; Crespo, Javier; Fábrega, Emilio

doi:10.1016/j.transproceed.2016.08.037

Cited by 7 publications

(18 citation statements)

References 13 publications

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“…(18) Del Bello et al reported a 34-month dnDSA prevalence of 14% using a 1,000 MFI cutoff, (16) and San Segundo et al reported a dnDSA prevalence at 77 months after transplantation of 17.8% using a 3,500 MFI cutoff. (19) Our findings are higher than previously reported; but our cohort was highly mismatched for seven HLA loci, and we used the 1,000 MFI cutoff to allow for the detection of low-level antibodies. Nevertheless, we confirmed previous findings that dnDSA were produced mostly against HLA-II antigens, especially HLA-DQ antigens.…”

Section: Discussioncontrasting

confidence: 61%

“…Fontana et al reported a lower long‐term (7 years) dnDSA prevalence (24.2%) . Del Bello et al reported a 34‐month dnDSA prevalence of 14% using a 1,000 MFI cutoff, and San Segundo et al reported a dnDSA prevalence at 77 months after transplantation of 17.8% using a 3,500 MFI cutoff . Our findings are higher than previously reported; but our cohort was highly mismatched for seven HLA loci, and we used the 1,000 MFI cutoff to allow for the detection of low‐level antibodies.…”

Section: Discussionmentioning

confidence: 52%

“…These observations suggest that dnDSA are associated with biopsy-proven findings (evidence of rejection or fibrosis) that disqualify patients from attempting IS withdrawal, which supports previous findings where DSA are associated with acute rejection, positive C4d staining, and fibrosis progression. (5,7,16,19) Consequently, it seems reasonable to question whether LT recipients should undergo significant IS minimization if, in the first year after transplantation, they have biopsyproven rejections that lead to the development of dnDSA.…”

Section: Discussionmentioning

confidence: 99%

“…There is no standard MFI cutoff in LT as the MFI cutoff used varies between 1,000 and 5,000. (14)(15)(16)(17)19) While high-titer dnDSA are the most deleterious in LT, (12,13,21) the characterization of low-titer dnDSA (target epitope, subclass, or complement fixation) remains challenging, (22) and their impact has not been fully clarified. Moreover, the prozone effect, usually defined as an increase of MFI when the serum is serially diluted, may hide the real titer of the dnDSA and may conceal the true titer of low MFI dnDSA.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and Impact of De Novo Donor‐Specific Antibodies During a Multicenter Immunosuppression Withdrawal Trial in Adult Liver Transplant Recipients

et al. 2019

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence and Impact of De Novo Donor‐Specific Antibodies During a Multicenter Immunosuppression Withdrawal Trial in Adult Liver Transplant Recipients

et al. 2019

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“…Reports of longterm (ranging from 34 months to 7 years) dnDSA prevalence in LTRs also widely vary ranging from 14.0% to 44.4%, although all showed that dnDSA were produced mostly against HLA-2 antigens, especially HLA-DQ antigens. (77,78,80,81) Studies seem to agree on an association between dnDSA and rejection in deceased donor LTRs, and the potential pathogenicity of HLA-DQ dnDSA in LTRs. (73,75,76,79) The controversy regarding the impact of pfDSA on outcomes for LTRs persists.…”

Section: Donor-specific Antibodiesmentioning

confidence: 99%

Genomics and Liver Transplantation: Genomic Biomarkers for the Diagnosis of Acute Cellular Rejection

2020

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Acute cellular rejection (ACR) is a common complication in liver transplantation recipients (LTRs), especially within the first 12 months, and it is associated with increased morbidity and mortality. Although abnormalities in standard liver biochemistries may raise the clinical suspicion for ACR, it lacks specificity, and invasive liver biopsies, which are associated with numerous risks, are required for definitive diagnoses. Biomarker discovery for minimally invasive tools for diagnosis and prognostication of ACR after liver transplantation (LT) has become a rapidly evolving field of research with a recent shift in focus to omics‐based biomarker discovery. Although none are yet ready to replace the standard of care, there are several promising minimally invasive, blood‐derived biomarkers that are under intensive research for the diagnosis of ACR in LTRs. These omics‐based biomarkers, encompassing DNA, RNA, proteins, and metabolites, hold tremendous potential. Some are likely to become integrated into ACR diagnostic algorithms to assist clinical decision making with a high degree of accuracy that is cost‐effective and reduces or even obviates the need for an invasive liver biopsy.

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Donor-specific antibodies in liver transplantation

Vionnet

Sempoux

Pascual

et al. 2020

Gastroenterología y Hepatología (English Edition)

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Despite unique immunoregulatory properties pointing toward tolerance, the liver allograft can be negatively impacted by humoral alloreactivity, with immediate as well as long-term harmful consequences. With regard to the unmet need of long-term outcomes improvement after liver transplantation, donor-specific antibodies have recently been the matter of intense study in this context. We review here recent advances regarding the understanding of the impact of preformed as well as de novo anti-human leukocyte antigen donor-specific antibodies in liver transplantation and discuss potential strategies to overcome this problem.

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De Novo Donor-Specific Anti–Human Leukocyte Antigen Antibody Detection in Long-Term Adult Liver Transplantation

Cited by 7 publications

References 13 publications

Prevalence and Impact of De Novo Donor‐Specific Antibodies During a Multicenter Immunosuppression Withdrawal Trial in Adult Liver Transplant Recipients

Prevalence and Impact of De Novo Donor‐Specific Antibodies During a Multicenter Immunosuppression Withdrawal Trial in Adult Liver Transplant Recipients

Genomics and Liver Transplantation: Genomic Biomarkers for the Diagnosis of Acute Cellular Rejection

Donor-specific antibodies in liver transplantation

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