Cargando…

Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation

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 divide...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709009/
https://www.ncbi.nlm.nih.gov/pubmed/34945772
http://dx.doi.org/10.3390/jpm11121300
_version_ 1784622828020039680
author 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
author_facet 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
author_sort Lee, Wei-Chen
collection PubMed
description 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.
format Online
Article
Text
id pubmed-8709009
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-87090092021-12-25 Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation 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 J Pers Med Article 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. MDPI 2021-12-05 /pmc/articles/PMC8709009/ /pubmed/34945772 http://dx.doi.org/10.3390/jpm11121300 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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
Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation
title Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation
title_full Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation
title_fullStr Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation
title_full_unstemmed Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation
title_short Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation
title_sort clinical relevance of isoagglutinin rebound in adult abo-incompatible living donor liver transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709009/
https://www.ncbi.nlm.nih.gov/pubmed/34945772
http://dx.doi.org/10.3390/jpm11121300
work_keys_str_mv AT leeweichen clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT leechenfang clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT wutsunghan clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT hunghaochien clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT leejinchiao clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT wangyuchao clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT chengchihhsien clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT wutingjung clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT chouhongshiue clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation
AT chankunming clinicalrelevanceofisoagglutininreboundinadultaboincompatiblelivingdonorlivertransplantation