Effect of HLA matching on liver graft survival

Muro, Manuel; Marı́n, Luis; Torı́o, Alberto; Moya‐Quiles, María Rosa; Ontañón, Jesús; Minguela, Alfredo; Alemany, J.; Sánchez‐Bueno, Francisco; García‐Alonso, Ana M.; Álvarez-López, María R.

doi:10.1016/s0041-1345(99)00425-x

Cited by 10 publications

(8 citation statements)

References 7 publications

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“…1,6,37,12,13 Indeed, recent research of our group showed that partial class I (HLA-A and HLA-B) compatibility may increase the incidence of AR in recipients with preoperative viral infections and that a total HLA-AϩBϩDR mismatch could enhance graft survival. 14,38 Interestingly, our results of the HLA-C allelic compatibility may suggest, for the first time, a beneficial effect of the HLA-C compatibility, compared with one or two mismatches on preventing AR and increasing 5-year graft survival, which is in contrast with results obtained for other HLA loci. 38 However, the reactivity of HLA-C alleles must be considered in terms of its recognition as classic HLA class I alloantigens and by its ability to interact with immunoglobulin-like receptors.…”

Section: Discussionmentioning

confidence: 61%

“…14,38 Interestingly, our results of the HLA-C allelic compatibility may suggest, for the first time, a beneficial effect of the HLA-C compatibility, compared with one or two mismatches on preventing AR and increasing 5-year graft survival, which is in contrast with results obtained for other HLA loci. 38 However, the reactivity of HLA-C alleles must be considered in terms of its recognition as classic HLA class I alloantigens and by its ability to interact with immunoglobulin-like receptors. It has been reported that the number of inhibitory KIR ligands produced by the HLA phenotype can correlate with the alloreactive potential of their NK cells, because NK cells will be alloreactive toward cells from individuals lacking the KIR ligands which he or she carries (missing-self hypothesis).…”

Section: Discussionmentioning

confidence: 61%

“…46 Together, these data show that in liver transplant, the HLA-C genotype of recipients especially appears to be related to early AR, whereas HLA-C compatibility can affect both the short-term and long-term transplant outcome, and NK-alloantigens compatibility mainly influence the long-term survival. Considering, that our previous data showed no effect of HLA-A or HLA-B matching in liver transplantation 38 and that there is a low expression of HLA class I in liver tissues, 47 it is tempting to hypothesize that liver HLA expression resembles that of the trophoblast, 48 in which HLA-C is the only one of the classic HLA class I antigens that is expressed. 49 Similarly, nonclassic HLA antigens, such as HLA-G, also may be expressed and be implicated in liver allograft acceptance.…”

Section: Discussionmentioning

confidence: 94%

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Human leukocyte antigen–C in short- and long-term liver graft acceptance

Moya‐Quiles

Muro

Torı́o

et al. 2003

Liver Transplantation

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In liver transplantion, rejection is still an important problem, and the role of human leukocyte antigens (HLA) has not been clearly established. At present, the possible involvement of HLA-C antigen in liver transplantation is still unexplored. The aim of this work was to analyze the influence of HLA-C polymorphism on the outcome of liver transplantation. For this purpose, genotyping of 100 orthotopic liver transplant recipient-donor pairs for HLA-C was performed with polymerase chain reactionsequence-specific primers (PCR-SSPs). Liver recipients were stratified according to the occurrence of acute rejection. Patients without acute rejection were found to have a lower frequency of the HLA-Cw*06 allele compared with those with acute rejection or the control group. Moreover, when the role of HLA-C dimorphism was analyzed, natural killer (NK)1-alloantigens were found to be predominant in recipients without acute rejection. When the match of HLA-C single alleles and NK-alloantigens between donor and recipient was analyzed, it appeared that the frequency of acute rejection gradually decreased with decrease of the number of allele mismatches. Graft survival was increased when the number of mismatches in both HLA-C or NK-alloantigens was lower. In conclusion, the HLA-C locus may play a role in liver graft alloreactivity or allotolerance and, therefore, may be useful to avoid acute rejection and to achieve graft acceptance, resulting in a better final outcome in liver transplantation. (Liver Transpl 2003;9:218-227.)

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 94%

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Human leukocyte antigen–C in short- and long-term liver graft acceptance

Moya‐Quiles

Muro

Torı́o

et al. 2003

Liver Transplantation

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“…A review of the literature on HLA mismatching in unselected liver transplant recipients 1,5,6,8,9,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] shows that most studies found no effects ( Table 3). The results in our unselected population of 799 adult liver transplant recipients were mostly consistent with such findings.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of human leukocyte antigen mismatching in liver transplantation: Results of the national institute of diabetes and digestive and kidney diseases liver transplantation database

et al. 2008

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A perfect or nearly perfect human leukocyte antigen (HLA) match has been associated with better immediate and long-term survival of diseased donor kidney transplants. However, the effect of HLA matching for hepatic allografts remains poorly defined. Using data from the National Institutes of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database, we investigated the association between HLA mismatches and hepatic allograft survival, disease recurrence, and immunosuppression interactions. A, B, and DR loci were used to calculate total mismatch scores of 0 (no mismatches in any loci) to 6 (mismatches in all loci). Seven hundred ninety-nine adults (male, 55%; female, 45%) underwent 883 liver transplants. The 10-year graft survival according to total mismatch score was as follows: 0-2, 60%; 3-4, 54%; and 5-6, 57%. There was a negative effect of mismatching at the A locus on patient survival, with shorter survival for patients with 1 or 2 mismatches compared with 0 mismatches [P ‫؍‬ 0.05, hazard ratio (HR) ‫؍‬ 1.6]. Patients on tacrolimus with 1 or 2 mismatches at B or DR loci appeared to have increased rates of patient and graft survival compared to patients with 0 mismatches, with the appearance of a protective effect of tacrolimus (HR ‫؍‬ 0.67). The effect of HLA mismatching was more pronounced on certain disease recurrences. DR-locus mismatch increased recurrence of autoimmune hepatitis (P ‫؍‬ 0.01, HR ‫؍‬ 4.2) and primary biliary cirrhosis (P ‫؍‬ 0.04, HR ‫؍‬ 2). Mismatch in the A locus was associated with more recurrence of hepatitis C virus (P ‫؍‬ 0.01, HR ‫؍‬ 1.6) and primary sclerosing cholangitis (P ‫؍‬ 0.03, HR ‫؍‬ 2.9). Conclusion: Mismatching at the A locus decreases patient survival in liver transplant recipients, and mismatching at the DR and A loci affects recurrence of autoimmune liver diseases and hepatitis C, respectively.

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“…HLA-A and -B class I antigens were determined using the standard microlymphocytotoxicity technique [20,21]. Sera set used for antigen determination included those generated in our centers, those supplied by participating laboratories in the Spanish Histocompatibility Workshops, well-defined commercial sera, and commercial typing trays (One Lambda, Los Angeles, CA, USA).…”

Section: Hla-a -B Typingmentioning

confidence: 99%