HISTOCOMPATIBILITY AND LIVER TRANSPLANT OUTCOME

作者：Hla Exert A Dualistic, Bernd H. Markus, René J. Duquesnoy, Robert D. Gordon, John J. Fung, Marian S. Vanek, Göran Bo Gustaf Klintmalm, C S Bryan, David Van Thiel, Thomas E. Starzl · 年份：1988 · 被引用次数：35 · 研究领域：Liver Diseases and Immunity、Renal Transplantation Outcomes and Treatments、Organ Transplantation Techniques and Outcomes

An analysis of more than 500 liver transplants has demonstrated that HLA compatibility is associated with diminished allograft survival. Liver transplants with zero mismatches for class I and/or class II HLA antigens have shown significantly lower actuarial survival rates than transplants with one or more mismatches for these loci. In a group of 119 failed liver allografts from pa­ tients undergoing retransplantation, a higher incidence of failure due to rejection correlated with a lower degree of HLA compatibility especially for HLA-DR. In con­ trast, the incidence of liver transplant failures due to primary nonfunction was relatively higher with HLA­ DR compatible transplants. Considering the role of HLA as a restriction element in cellular interactions during the immune response. these findings suggest that HLA compatibility may have a dualistic effect on liver trans­ plant outcome. On one hand, HLA compatibility reduced transplant rejection-and on the other hand, it may enhance other immunological mechanisms leading to al­ lograft dysfunction, particularly in patients at risk of developing recurrent autoimmune diseases or infection. 1 Recipient of a Research Fellowship from the Deutsche Forschungs­