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The influence of HLA matching on cytomegalovirus hepatitis and chronic rejection after liver transplantation

Mañez, R and White, LT and Linden, P and Kusne, S and Martin, M and Kramer, D and Demetris, AJ and Van Thiel, DH and Starzl, TE and Duquesnoy, RJ (1993) The influence of HLA matching on cytomegalovirus hepatitis and chronic rejection after liver transplantation. Transplantation, 55 (5). 1067 - 1071. ISSN 0041-1337

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Abstract

Previous findings in liver transplantation patients have raised the concept that HLA plays a dualistic role. HLA matching will reduce rejection but may augment MHC restricted cellular immune mechanisms of liver allograft injury. To evaluate this concept, we studied CMV hepatitis in 399 FK506-treated liver transplant patients, including 355 cases for which complete HLA-A, B, DR, DQ typing information was available. CMV hepatitis developed in 25 patients, and 17 of them (or 68%) showed a one or two HLA-DR antigen match with the donor. In contrast, HLA-DR matches were found in only 35% of 330 patients without CMV hepatitis (P=0.005). No significant associations were seen for HLA-A, HLA-B, and HLA-DQ antigens. In pretransplant CMV-seronegative patients with seropositive grafts (n=39), the frequency of CMV hepatitis was 44% for HLA-DR-matched livers but 14% for HLA-DR-un-matched livers. In seropositive recipients (n=187), these frequencies were 12% and 2% for HLA-DR-matched and unmatched liver grafts. Chronic rejection developed in 29 patients (or 8%) during a follow-up between 10 and 24 months after transplantation. Its incidence was higher in the CMV hepatitis group (24% vs. 6%) (P=0.007). Although no associations were found between HLA matching and the incidence of chronic rejection, there was an earlier onset of chronic rejection of HLA-DR-matched livers irrespective of CMV hepatitis. These findings suggest that an HLA-DR match between donor and recipient increases the incidence of CMV hepatitis in both primary and secondary CMV infections. Although HLA compatibility leads to less acute cellular rejection, it is suggested that DR matching may accelerate chronic rejection of liver transplants, perhaps through HLA-DR-restricted immunological mechanisms toward viral antigens, including CMV. © 1993 by Williams and Wilkins.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mañez, R
White, LT
Linden, P
Kusne, S
Martin, M
Kramer, D
Demetris, AJ
Van Thiel, DH
Starzl, TEtes11@pitt.eduTES11
Duquesnoy, RJ
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1993
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 55
Number: 5
Page Range: 1067 - 1071
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062112424, Starzl CV No. 1453
Date Deposited: 08 Apr 2010 17:24
Last Modified: 13 Oct 2017 21:57
URI: http://d-scholarship.pitt.edu/id/eprint/4839

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