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Donor HLA Evolutionary Divergence May Predict Liver Transplant Rejection

Class I HED of the donor is associated with higher risk for acute and chronic rejection of the liver transplant

TUESDAY, Aug. 24, 2021 (HealthDay News) — Class I human leukocyte antigen (HLA) evolutionary divergence (HED) of liver transplant donors is associated with acute and chronic rejection, according to a study published online Aug. 24 in the Annals of Internal Medicine.

Cyrille Féray, M.D., Ph.D., from the Université Paris-Saclay, and colleagues examined the potential effect of donor or recipient HED on liver transplant rejection in a retrospective cohort study. Data were included for 1,154 adults and 113 children who had a liver transplant between 2004 and 2018. The influence of HED on the incidence of liver lesions was examined.

The researchers found that class I HED of the donor was associated with acute rejection, chronic rejection, and ductopenia of 50 percent or more in adults (hazard ratios, 1.09, 1.20, and 1.33, respectively), but not with other histologic lesions. Donor class I HED was associated with acute rejection in children (hazard ratio, 1.16), irrespective of the presence of donor-specific anti-HLA antibodies. Neither donor class II HED nor recipient class I or class II HED had an effect on the incidence of liver lesions in adults or children.

“From a practical standpoint, HED can be determined rapidly at no additional cost as soon as the HLA genotype of the donor is available,” the authors write. “The availability of donor HED could allow for better allocation of liver grafts when possible; for example, by avoiding donors with high HED values for recipients at high risk for rejection.”

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