We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation.
- Authors
Lee, Wei-Chen; Lee, Chen-Fang; Wu, Tsung-Han; Hung, Hao-Chien; Lee, Jin-Chiao; Wang, Yu-Chao; Cheng, Chih-Hsien; Wu, Ting-Jung; Chou, Hong-Shiue; Chan, Kun-Ming
- Abstract
ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) can be performed successfully. However, anti-ABO isoagglutinin rebound may cause antibody-mediated rejection (AMR) and graft loss. The risk threshold of isoagglutinin rebound is still not defined. 76 ABO-I LDLT recipients were divided into group A (n = 56) with low isoagglutinin titers (<1:256), and group B (n = 20) with high isoagglutinin titers (≥1:256), at initial assessment for liver transplantation. The last 12 patients in group B received a modified desensitization regimen by adding bortezomib to deplete plasma cells. Six (10.7%) patients in group A and 10 (50.0%) patients in group B had postoperative isoagglutinin rebound (p < 0.001). Three patients (5.54%) in group A and two patients (10%) in group B developed clinical AMR (p = 0.602). The cutoff value of postoperative isoagglutinin rebound to cause clinical AMR was ≥1:1024. Among the 12 patients in group B with bortezomib administration, isoagglutinin rebounded up to 1:128 only, and no clinical AMR occurred. In conclusion, the patients with high isoagglutinin titers had a higher rate of postoperative isoagglutinin rebound. Isoagglutinin rebound ≥1:1024 is risky for developing clinical AMR. Adding bortezomib into the desensitization regimen may mitigate isoagglutinin rebound, and avoid clinical AMR.
- Subjects
LIVER transplantation; BLOOD group incompatibility; GRAFT rejection; ADULTS; PLASMA cells
- Publication
Journal of Personalized Medicine, 2021, Vol 11, Issue 12, p1300
- ISSN
2075-4426
- Publication type
Article
- DOI
10.3390/jpm11121300