P264 HLA antibody and liver transplantation

Aim HLA match is important to solid organ transplantation, especially to kidney and thoracic transplant. However, HLA antibody and matches to liver transplant are still critical topics figure out whether liver graft can develop antibody mediated rejection or protect other solid organ transplant. This study is focusing on monitoring pre- and post-transplant DSA of liver transplant to figure out the importance of HLA CI and CII antibody for liver and other organ transplantation. Methods Eight patients with liver transplant only and one patient received liver and kidney. All donors were no DCD donor but either EBV or CMV positive. Solid phase assay: Luminex HLA single antigen beads. Results 1. Two patients had pre HLA CI DSA. After 2–4 days of transplant, CI DSAs were disappeared and other CI antibodies within the same CREG of DSA were disappeared as well. One patient had DSA as B60 as in Fig. and DSA B60 disappeared after 4 days of transplant. 2. Three patients had pre HLA CII DSA. After liver transplanted, CII DSAs were not disappeared and CII DSA’s MFIs went up higher than pre transplant; there was one patient without DSA, when liver function became abnormal, this patient developed HLA CI and CII DSA; for the patient with liver and kidney transplant, liver graft can’t protect the kidney’s AMR caused from CII DSA (see Table). Conclusions The results indicate that if the patients with liver transplant have HLA CI DSA and functional liver, CI DSA will be cleaned soon after grafted and other CI antibody within the same CREG of DSA will be cleaned as well. If the liver graft failed or infected, the patient will develop both CI and CII DSA. There is a high rate of CII DSA detected after liver transplant. More cases will be collected in order to confirm the indication above. Download high-res image (474KB) Download full-size image Download high-res image (112KB) Download full-size image