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...
Autores principales: | , , , , , , , , , |
---|---|
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 |