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ORIGINAL RESEARCH article

Front. Nephrol.
Sec. Kidney Transplantation
Volume 4 - 2024 | doi: 10.3389/fneph.2024.1403096

THE FATE OF ANTI-HLA ANTIBODIES FOLLOWING LIVER TRANSPLANTATION

Provisionally accepted
Douglas J. Norman Douglas J. Norman *C. K. Enestvedt C. K. Enestvedt Willscott E. Naugler Willscott E. Naugler Rouella Erhan Rouella Erhan Carley A. Shaut Carley A. Shaut
  • Oregon Health and Science University, Portland, United States

The final, formatted version of the article will be published soon.

    INTRODUCTION: Liver transplant recipients may have pre-formed anti-HLA antibodies directed to mismatched HLA of the liver donor (donor specific antibodies, DSA) or not directed to the liver donor (non-donor specific, non-DSA). We observed the natural history of these antibodies (DSA and non-DSA) at 12 months after transplant. METHODS: Patients transplanted between 4/2015 and 12/2018 (N = 216) who had anti-HLA antibody measurements at both transplant and 12 months posttransplant (N = 124) and with DSAs at transplant (N = 31) were considered informative for a paired analysis of the natural history of DSA and non-DSA following liver transplantation. RESULTS: Class I DSAs and non-DSAs decreased between transplant and 12 months; however, Class I DSAs essentially disappeared by 12 months while Class I non-DSAs did not. Anti-HLA Class II DSAs performed differently. While there was a significant drop in values between transplant and 12 months, these antibodies mostly persisted at a low level. DISCUSSION: Our study demonstrated a significant difference in the kinetics of DSA compared to non-DSA following liver transplantation, most profoundly for anti-HLA Class I antibodies. Class I DSAs were mostly absent at 12 months while Class II DSAs persisted, although at lower levels. The mechanisms of reduction in anti-HLA antibodies following liver transplantation are not completely understood and were not pursued as a part of this study. This detailed analysis of Class I and Class II DSAs and non-DSAs represents the first study to explore the change in antibodies at one year from liver transplantation.

    Keywords: liver transplant, anti HLA antibodies, Donor specific antibodies, HLA Class I and Class II Typing, Liver Graft Survival

    Received: 18 Mar 2024; Accepted: 13 May 2024.

    Copyright: © 2024 Norman, Enestvedt, Naugler, Erhan and Shaut. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Douglas J. Norman, Oregon Health and Science University, Portland, United States

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