Your browser doesn't support javascript.
loading
The Consequences of HLA Screening in the Prevention of Graft-Versus-Host Disease in Living Donor Liver Transplantation.
Ercan, Leman Damla; Durmaz, Özlem; Kaymakoglu, Sabahattin; Önal, Zerrin; Büyükbabani, Nesimi; Güllüoglu, Mine; Alper, Aydin; Ibis, Cem; Cantez, Serdar; Yavru, Hacer Aysen; Oguz, Fatma Savran; Özden, Ilgin.
Afiliación
  • Ercan LD; Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Durmaz Ö; Department of Pediatrics (Gastroenterology), Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Kaymakoglu S; Department of Internal Medicine (Gastroenterology), Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Önal Z; Department of Pediatrics (Gastroenterology), Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Büyükbabani N; Department of Pathology, Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Güllüoglu M; Department of Pathology, Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Alper A; Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Ibis C; Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Cantez S; Department of Pediatrics (Gastroenterology), Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Yavru HA; Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Oguz FS; Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul, Turkey.
  • Özden I; Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey.
Pediatr Transplant ; 28(6): e14846, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39177044
ABSTRACT

AIMS:

To study the effects of routine HLA screening and the policy of avoiding donor-dominant one-way HLA match to prevent graft-versus-host disease (GVHD) after living donor liver transplantation (LDLT). PATIENTS AND

METHODS:

The records of potential living liver donors and recipients who attended our center between 2007 and 2018 were reviewed retrospectively.

RESULTS:

Of the 149 patients who underwent LDLT and survived longer than 3 months, two developed GVHD despite our strict policy. The first patient presented with grade II GVHD limited to the skin. She was treated successfully by briefly discontinuing immunosuppression and switching to everolimus. In the second case, the policy had been relaxed due to the availability of a single donor for ABO-incompatible transplantation without any intervention to decrease anti-A antibody levels (special case A2 to O). Nevertheless, the patient presented with grade I GVHD limited to skin and was treated successfully by adding oral methylprednisolone to tacrolimus and mycophenolate mofetil. To the best of our information, this is the second reported case who recovered from GVHD after LDLT from a donor, homozygous at HLA A, B and DR and a recipient, heterozygous for all. Sixteen potential donors (1.2% of all candidates) of 14 recipients were disqualified solely on the basis of the HLA results; five of these patients died due to unavailability of another donor.

CONCLUSION:

The results support the policy of avoiding HLA combinations that preclude immune recognition of graft lymphocytes as foreign to decrease the risk of GVHD after LDLT.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prueba de Histocompatibilidad / Trasplante de Hígado / Donadores Vivos / Enfermedad Injerto contra Huésped / Antígenos HLA Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Pediatr Transplant Asunto de la revista: PEDIATRIA / TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Dinamarca
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prueba de Histocompatibilidad / Trasplante de Hígado / Donadores Vivos / Enfermedad Injerto contra Huésped / Antígenos HLA Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Pediatr Transplant Asunto de la revista: PEDIATRIA / TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Dinamarca