Trial reportAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2020
IgG4 donor-specific HLA antibody profile is associated with subclinical rejection in stable pediatric liver recipients.
Trial report in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed.
- IgG Subclass Profiles of HLA Antibodies Enhance Prediction of C1q-Binding in Kidney Transplant Recipients.Diagnostics (Basel, Switzerland) · 2026Article
- Diagnostic and predictive biomarkers of acute rejection after liver transplantation.International journal of surgery (London, England) · 2025Review
- Human leukocyte antigen and donor-specific antibodies in liver transplantation.World journal of gastroenterology · 2025Article
- Interrogating post-transplant donor HLA-specific antibody characteristics and effector functions using clinical bead assays.Human immunology · 2024Article
- Molecular states during acute COVID-19 reveal distinct etiologies of long-term sequelae.Nature medicine · 2023Article
- The Clinical Utility of Post-Transplant Monitoring of Donor-Specific Antibodies in Stable Renal Transplant Recipients: A Consensus Report With Guideline Statements for Clinical Practice.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- The New Challenge in Pediatric Liver Transplantation: Chronic Antibody-Mediated Rejection.Journal of clinical medicine · 2022Review
- A network-based approach to identify expression modules underlying rejection in pediatric liver transplantation.Cell reports. Medicine · 2022Article
- Kidney transplantation in highly sensitized recipients.Kidney research and clinical practice · 2021Article
- The role of the gut microbiome in graft fibrosis after pediatric liver transplantation.Human genetics · 2021Review
- Efficacy and Safety of Immunosuppression Withdrawal in Pediatric Liver Transplant Recipients: Moving Toward Personalized Management.Hepatology (Baltimore, Md.) · 2021Article
- Sensitization in transplantation: Assessment of risk (STAR) 2019 Working Group Meeting Report.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020Review
- Essential updates 2018/2019: Liver transplantation.Annals of gastroenterological surgery · 2020Review
- Strategies for Deliberate Induction of Immune Tolerance in Liver Transplantation: From Preclinical Models to Clinical Application.Frontiers in immunology · 2020Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
The impact of donor-specific HLA antibody (DSA) following liver transplantation remains controversial. We hypothesized DSA IgG subclass characteristics, compared to total DSA IgG, might correlate with specific histopathological phenotype(s) of subclinical graft injury. We therefore studied 129 stable, arguably "clinically ideal," pediatric liver recipients at the time of a screening biopsy to enter an immunosuppression withdrawal trial. Sixty-five (50%) subjects tested positive for class II DSA. IgG subclass profile was characterized by mean fluorescence intensity (MFI) and normalized subclass composition (>5%). A prominent IgG4 DSA profile was strongly correlated with greater HLA mismatch, a histopathological phenotype characterized by the presence of interface activity (with variable degrees of fibrosis), and a transcriptional profile of attenuated T cell-mediated rejection. Specifically, compared to those without class II DSA, those with IgG4 class II DSA MFI sum >2000 exhibited an odds ratio (OR) of 20.79 (95% confidence interval [CI] 4.38-98.69) and IgG4 subclass composition >5% exhibited an OR of 8.99 (95% CI 2.70-29.9). Our data suggest that IgG4 DSA may serve as a useful biomarker to identify, among clinically and biochemically stable liver transplant recipients, a subset with histological and transcriptional features indicative of an active, suboptimally controlled alloimmune response.
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