Evidence map›Paper›PMID 41894252›Full record

ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2026

Preformed donor-specific antibodies are associated with acute rejection and biliary complications after liver transplantation: A Swiss Transplant Cohort Study analysis.

Julien Vionnet, Sylvie Ferrari-Lacraz, Linard David Hoessly, Antonio Mancarella, Yannick D Müller, Stefan Schaub, Jakob Nilsson, Urs Wirthmüller, Susanne Stampf, Michael Koller and 27 more

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Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

37 authors.

Julien VionnetTransplantation Centre, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID 0000-0002-1654-0488
Sylvie Ferrari-LacrazTransplant Immunology Unit and National Histocompatibility Laboratory of Reference, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Linard David HoesslySwiss Transplant Cohort Study, University Hospital Basel, Basel, Switzerland.
Antonio MancarellaService of Immunology and Allergy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Yannick D MüllerService of Immunology and Allergy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Stefan SchaubHLA-Diagnostic and Immunogenetics Laboratory, University Hospital Basel, Basel, Switzerland.
Jakob NilssonDepartment of Immunology, University Hospital Zürich, Zürich, Switzerland.ORCID 0000-0001-5091-8133
Urs WirthmüllerCentre for Laboratory Medicine, University Hospital Bern, Bern, Switzerland.
Susanne StampfSwiss Transplant Cohort Study, University Hospital Basel, Basel, Switzerland.
Michael KollerSwiss Transplant Cohort Study, University Hospital Basel, Basel, Switzerland.
Nicolas J MuellerDepartment of Infectious Diseases and Hospital Epidemiology, University Hospital Zürich, Zürich, Switzerland.
Myriam AmrariTransplantation Centre, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Oriol ManuelTransplantation Centre, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Dela GolshayanTransplantation Centre, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Montserrat FragaService of Gastroenterology and Hepatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Darius MoradpourService of Gastroenterology and Hepatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID 0000-0003-1977-6792
Nicolas GoossensService of Transplantation, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.ORCID 0000-0002-8698-4690
Giulia MaginiService of Transplantation, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Philippe CompagnonService of Transplantation, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Valérie McLinDepartment of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Nathalie RockDepartment of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.ORCID 0000-0001-5315-9267
Barbara WildhaberDepartment of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Andreas E KremerDepartment of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.ORCID 0000-0002-9263-948
Jose OberholzerDepartment of Surgery and Transplantation, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
Richard Xavier Sousa Da SilvaDepartment of Surgery and Transplantation, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
Pascale TinguelyDepartment of Surgery and Transplantation, University Hospital Zürich, University of Zürich, Zürich, Switzerland.ORCID 0000-0001-6836-8045
Loreta KavaliukaiteDepartment of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
Annalisa BerzigottiDepartment of Visceral Surgery and Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
Vanessa BanzDepartment of Visceral Surgery and Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.ORCID 0000-0002-4887-5776
Christine BernsmeierUniversity Centre for Gastrointestinal and Liver Diseases, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-5558-0503
Philipp DutkowskiUniversity Centre for Gastrointestinal and Liver Diseases, University Hospital Basel, Basel, Switzerland.
David SemelaDivision of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Matthias NiemannPIRCHE AG, Berlin, Germany.
Giuseppe PantaleoService of Immunology and Allergy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Manuel PascualTransplantation Centre, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Jean VillardTransplant Immunology Unit and National Histocompatibility Laboratory of Reference, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
and the Swiss Transplant Cohort Study (STCS)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The impact of preformed donor-specific antibodies (DSA) in liver transplantation (LT) remains controversial despite evidence linking their presence to an increased risk of early allograft damage, as well as antibody- and T-cell-mediated rejection. In this nationwide analysis, preformed DSA were assessed using single-antigen bead assays [positive if mean fluorescence intensity (MFI) ≥1000]. This study included all LT recipients enrolled in the Swiss Transplant Cohort Study (STCS) who underwent LT between 2014 and 2016. One-year post-LT outcomes, including cumulative allograft and patient survival, as well as the incidence of biliary, vascular, and infectious complications, were compared between DSA-positive (DSA+) and DSA-negative (DSA-) individuals. Among 321 LT performed in 306 patients, preformed DSA were detected in 92 (28.7%) and more frequently observed in patients with a history of prior transplantation ( p =0.008) or autoimmune liver disease ( p =0.036). Class I and II DSA were present in 48.9% and 71.1% of DSA+ cases, with concomitant class I and II DSA in 20.7%. The median (IQR) cumulative MFI (cMFI) of the preformed DSA was 3768 (1875-10,537), and 52.2% of DSA+ patients harbored multiple DSA. While overall patient survival did not differ between DSA+ and DSA- individuals, DSA+ patients with cMFI ≥5000 exhibited a higher incidence of allograft failure and biopsy-proven rejection. Multivariate analysis revealed that the presence of preformed DSA was independently associated with biliary complications (HR 2.26, 95% CI 1.17-4.37, p =0.02) but not with vascular or infectious complications. In summary, preformed DSA were associated with biliary complications, increased rejection, and reduced allograft survival. These findings suggest pre-transplant immunological risk assessment and the need for tailored immunosuppressive strategies in LT.

Indexed as

Biliary Tract DiseasesEnd Stage Liver DiseaseGraft RejectionHLA AntigensIsoantibodiesLiver TransplantationAdultAgedAllograftsFemaleGraft SurvivalHumansIncidenceMaleMiddle AgedRetrospective StudiesHLA AntigensIsoantibodiesallograft survivalbile duct diseasesDSAHLAimmunological risk stratificationSTCST-cell–mediated rejection

Identifiers

PMID41894252
PMCPMC13275070

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