The fate of anti-HLA antibodies following liver transplantation

Douglas J. Norman, C. K. Enestvedt, W. Naugler, Rouella Erhan, C. Shaut
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Abstract

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 fate of these antibodies (DSA and non-DSA) at 12 months after transplant.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.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.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 and important study to explore the change in antibodies at one year from liver transplantation.
肝移植后抗 HLA 抗体的命运
肝移植受者可能会预先形成针对肝脏供体不匹配的 HLA 的抗 HLA 抗体(供体特异性抗体,DSA)或不针对肝脏供体的抗 HLA 抗体(非供体特异性抗体,non-DSA)。我们观察了这些抗体(DSA和非DSA)在移植后12个月的去向。2015年4月至2018年12月期间移植的患者(N = 216)在移植时和移植后12个月都进行了抗HLA抗体测量(N = 124),且移植时存在DSA(N = 31),我们认为这些患者对肝移植后DSA和非DSA的自然史进行配对分析具有参考价值。I 类 DSA 和非 DSA 在移植至 12 个月期间有所减少;但是,I 类 DSA 在 12 个月前基本消失,而 I 类非 DSA 则没有消失。抗 HLA II 类 DSA 的表现有所不同。我们的研究表明,肝移植后 DSA 的动力学与非 DSA 相比有显著差异,其中抗 HLA I 类抗体的差异最大。我们的研究表明,肝移植后DSA的动力学与非DSA相比存在显著差异,其中抗HLA I类抗体的差异最大。肝移植后抗-HLA抗体减少的机制尚未完全明了,本研究也未对此进行探讨。这项对 I 类和 II 类 DSAs 以及非 DSAs 的详细分析是探索肝移植一年后抗体变化的一项重要研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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