Impact of HLA-compatibilities in patients undergoing liver transplantation for HBV-cirrhosis

Clin Transplant. 2002 Apr;16(2):122-9. doi: 10.1034/j.1399-0012.2002.1o008.x.

Abstract

Liver transplantation (OLT) for end-stage chronic hepatitis-B-virus (HBV) infection is frequently complicated by HBV recurrence. In the present study we investigated whether human leucocyte antigen (HLA)-matching influences the outcome after OLT. In a retrospective analysis we reviewed 84 recipients of liver transplants for end-stage HBV-cirrhosis and complete HLA-typing for outcome after OLT. Follow-up ranges from 1 to 110 months (median = 55.6 months). Immunosuppression consisted of Cyclosporin A (CsA)-based quadruple induction therapy or Tacrolimus-based induction protocols. Immunoprophylaxis with hepatitis B immunoglobulin was started at OLT and continued long-term. Actuarial 1- and 5-yr graft survival figures were 90.5 and 80.4%, respectively. Hepatitis-B recurrence was responsible for 15 of 20 (75%) graft failures. We observed a significantly improved graft survival in patients with more HLA-A, -B compatibilities (p = 0.02), whereas the degree of HLA-DR compatibilities did not influence the outcome. The occurrence of HBV-reinfection was significantly lower in HLA-A, -B matched grafts (p < 0.05). Additionally, graft survival was prolonged in patients with HBV-reinfection and 1 or 2 HLA-B compatibilities when compared with patients with HBV-reinfection and a complete HLA-B mismatch (p = 0.02). In conclusion, this retrospective analysis shows that more HLA-A, -B compatibilities seems to be associated with an improved graft survival in patients after OLT for end-stage HBV infection.

MeSH terms

  • Graft Survival
  • HLA-A Antigens / analysis
  • HLA-B Antigens / analysis
  • HLA-DR Antigens / analysis
  • Hepatitis B, Chronic / prevention & control
  • Hepatitis B, Chronic / surgery*
  • Histocompatibility Testing*
  • Humans
  • Immunization, Passive
  • Immunoglobulins / therapeutic use
  • Liver Cirrhosis / surgery*
  • Liver Cirrhosis / virology
  • Liver Transplantation / immunology*
  • Liver Transplantation / mortality
  • Recurrence
  • Retrospective Studies
  • Survival Rate

Substances

  • HLA-A Antigens
  • HLA-B Antigens
  • HLA-DR Antigens
  • Immunoglobulins
  • hepatitis B hyperimmune globulin