ArticleClinical transplantation2025
Assessment of Donor-Specific Human Leukocyte Antigen Antibodies Following Pediatric Liver Transplantation: Predictors, Protectors, and Clinical Relevance.
Article in Clinical transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- An Approach to Antibody-Mediated Rejection in Pediatric Liver Transplantation.Pediatric transplantation · 2026Review
- Assessment of Donor-Specific Human Leukocyte Antigen Antibodies Following Pediatric Liver Transplantation: Predictors, Protectors, and Clinical Relevance.Clinical transplantation · 2025Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFollowing pediatric liver transplantation (pLT), the significance and management of donor-specific antibodies (DSA) against human leukocyte antigen (HLA) remain undefined. The aim of this single-center study was to investigate the occurrence of DSA, their clinical impact on predictors for and protectors against DSA. PATIENTS AND
methodsWe compared anti-HLA DSA (cutoff for mean fluorescence intensity (MFI) ≥ 1000), clinical and laboratory results and outcome in a routine (RG, n = 142, standard DSA testing) and a hepatopathy group (HG, n = 19, DSA testing following indeterminate hepatopathy) in 161 pLT patients, treated 2000-2021, retrospectively.
results40% of RG and 32% of HG patients were DSA+ (39% of all patients, of which 13% with antibody-mediated rejection [AMR]). Most frequent DSA subtypes were HLA-DQ3, -DQ1, -DQ2 in RG and HLA-DQ2, -DR15 in HG. MFI was higher for anti-HLA II DSA (15 257 DSA+ vs. 5500 DSA-, p = 0.003), especially with AMR (21 000 DSA+ with AMR vs. 14 584 DSA+ without AMR, p = 0.042). Predictors for DSA included age at pLT, re-pLT, and cystic fibrosis. Living donation and cold ischemia time <8 h appeared to offer protection. Graft survival was poorer with DSA (RG 78% DSA+ vs. 97% DSA-, p = 0.018, HG 67% DSA+ vs. 100% DSA-, p = 0.0007). Patient survival was 97% for the entire cohort.
conclusionsDSA were detectable in 39% and associated with AMR in 13% of children post-pLT in addition to worse graft survival in all patients. Patient survival of 97% was not influenced. Potential DSA and predictors and protectors were identified. Therefore, DSA diagnostics are recommended after pLT.
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