The Lymphocytotoxic Crossmatch in Liver Transplantation: A Clinicopathologic Analysis

PREFORMED donor-reactive antibodies in kidney transplantation predispose to accelerated or precipitous graft failure, sometimes within hours after transplantation (hyperacute rejection).1 However, liver allografts have been shown to be resistant to this form of injury.2 Improvements in surgical techniques, preservation methods, patient selection and management,3 as weli as the introduction of the new immunosuppressant, FK 506,4 have improved early liver allograft survival, reducing many of the nonimmunologic causes of early graft dysfunction. This study was undertaken with consent on a subset of patients previously reported showing a deleterious effect of lymphocytotoxic antibodies.5 We wanted to determine the effect, if any, of preformed lymphocytotoxic antibodies on early liver allograft function and histology, and determine whether immunologic injury to the graft could be detected. The following is an overview of our results, to be presented in detail elsewhere.6