One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in Korea
Background : Graft-versus-host disease (GVHD) is a rare, but potentially fatal complication of liver transplantation. One-way human leukocyte antigens (HLA) mismatch has emerged as a risk factor for GVHD. However, the risk of mortality associated with HLA-one-way mismatch (OWMM) remains uncertain. W...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Transplantation
2023-12-01
|
| Series: | Korean Journal of Transplantation |
| Subjects: | |
| Online Access: | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0053 |
| _version_ | 1827387700159709184 |
|---|---|
| author | Seung Hyuk Yim Deok-Gie Kim Jae Geun Lee Dong Jin Joo Myoung Soo Kim |
| author_facet | Seung Hyuk Yim Deok-Gie Kim Jae Geun Lee Dong Jin Joo Myoung Soo Kim |
| author_sort | Seung Hyuk Yim |
| collection | DOAJ |
| description | Background : Graft-versus-host disease (GVHD) is a rare, but potentially fatal complication of liver transplantation. One-way human leukocyte antigens (HLA) mismatch has emerged as a risk factor for GVHD. However, the risk of mortality associated with HLA-one-way mismatch (OWMM) remains uncertain. We investigated the incidence and characteristics of GVHD. Methods : In total, 899 patients who underwent liver transplantation at a single center were retrospectively reviewed. The incidence of GVHD and 1- and 5-year survival rates were compared according to whether HLA-OWMM developed. Results : In the HLA-OWMM group, GVHD developed in two patients (14.3%). Notably, GVHD was only observed in living donor liver transplant (LDLT) recipients in the HLA-OWMM group. The HLA-OWMM group exhibited a lower 1-year patient survival rate than the control (i.e., non-HLA-OWMM) group (78.6% vs. 90.7%, P=0.120). However, the 5-year survival rate in the HLA-OWMM group was similar to that in the control group (78.6% vs. 78.2%, P=0.821). When the HLA-OWMM group was further stratified by the number of mismatched loci, the 5-year survival rate was 83.3% in patients with HLA-OWMM at one to two loci and 75.0% in those with HLA-OWMM at three loci. Conclusions: Despite the higher incidence of GVHD in LDLT recipients with HLA-OWMM, the 5-year patient survival rates were comparable to those in recipients without HLA-OWMM. The decision to perform LDLT in patients with HLA-OWMM depends on the patient’s status and the organ supply of a specific region. |
| first_indexed | 2024-03-08T16:06:04Z |
| format | Article |
| id | doaj.art-0b1c3a35f4e74b608da7b05900c927ac |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T16:06:04Z |
| publishDate | 2023-12-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-0b1c3a35f4e74b608da7b05900c927ac2024-01-08T05:34:02ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902023-12-0137426927610.4285/kjt.23.0053kjt.23.0053One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in KoreaSeung Hyuk Yim0Deok-Gie Kim1Jae Geun Lee2Dong Jin Joo3Myoung Soo Kim4Department of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, KoreaDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, KoreaDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, KoreaDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, KoreaDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, KoreaBackground : Graft-versus-host disease (GVHD) is a rare, but potentially fatal complication of liver transplantation. One-way human leukocyte antigens (HLA) mismatch has emerged as a risk factor for GVHD. However, the risk of mortality associated with HLA-one-way mismatch (OWMM) remains uncertain. We investigated the incidence and characteristics of GVHD. Methods : In total, 899 patients who underwent liver transplantation at a single center were retrospectively reviewed. The incidence of GVHD and 1- and 5-year survival rates were compared according to whether HLA-OWMM developed. Results : In the HLA-OWMM group, GVHD developed in two patients (14.3%). Notably, GVHD was only observed in living donor liver transplant (LDLT) recipients in the HLA-OWMM group. The HLA-OWMM group exhibited a lower 1-year patient survival rate than the control (i.e., non-HLA-OWMM) group (78.6% vs. 90.7%, P=0.120). However, the 5-year survival rate in the HLA-OWMM group was similar to that in the control group (78.6% vs. 78.2%, P=0.821). When the HLA-OWMM group was further stratified by the number of mismatched loci, the 5-year survival rate was 83.3% in patients with HLA-OWMM at one to two loci and 75.0% in those with HLA-OWMM at three loci. Conclusions: Despite the higher incidence of GVHD in LDLT recipients with HLA-OWMM, the 5-year patient survival rates were comparable to those in recipients without HLA-OWMM. The decision to perform LDLT in patients with HLA-OWMM depends on the patient’s status and the organ supply of a specific region.http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0053human leukocyte antigen; graft vs host disease; liver transplantation |
| spellingShingle | Seung Hyuk Yim Deok-Gie Kim Jae Geun Lee Dong Jin Joo Myoung Soo Kim One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in Korea Korean Journal of Transplantation human leukocyte antigen; graft vs host disease; liver transplantation |
| title | One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in Korea |
| title_full | One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in Korea |
| title_fullStr | One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in Korea |
| title_full_unstemmed | One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in Korea |
| title_short | One-way donor-to-recipient human leukocyte antigen mismatch and graft-versus-host disease in liver transplantation: an observational study of a single-center experience in Korea |
| title_sort | one way donor to recipient human leukocyte antigen mismatch and graft versus host disease in liver transplantation an observational study of a single center experience in korea |
| topic | human leukocyte antigen; graft vs host disease; liver transplantation |
| url | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0053 |
| work_keys_str_mv | AT seunghyukyim onewaydonortorecipienthumanleukocyteantigenmismatchandgraftversushostdiseaseinlivertransplantationanobservationalstudyofasinglecenterexperienceinkorea AT deokgiekim onewaydonortorecipienthumanleukocyteantigenmismatchandgraftversushostdiseaseinlivertransplantationanobservationalstudyofasinglecenterexperienceinkorea AT jaegeunlee onewaydonortorecipienthumanleukocyteantigenmismatchandgraftversushostdiseaseinlivertransplantationanobservationalstudyofasinglecenterexperienceinkorea AT dongjinjoo onewaydonortorecipienthumanleukocyteantigenmismatchandgraftversushostdiseaseinlivertransplantationanobservationalstudyofasinglecenterexperienceinkorea AT myoungsookim onewaydonortorecipienthumanleukocyteantigenmismatchandgraftversushostdiseaseinlivertransplantationanobservationalstudyofasinglecenterexperienceinkorea |