Donor-specific antibodies in liver transplantation: challenges in diagnosis and determining clinical impact.

Donor-specific antibodies in liver transplantation: challenges in diagnosis and determining clinical impact.
Curr Opin Organ Transplant. 2020 Dec;25(6):549-554
Authors: Kim SC, Foley DP
Abstract
PURPOSE OF REVIEW: Our understanding of the clinical impact of donor-specific antibodies in liver transplant recipients has evolved in recent years as outcomes for liver allografts have improved and advances in diagnostic testing have made recognition of antibody mediated rejection in transplant patients more sensitive.
RECENT FINDINGS: Two main types of donor-specific antibodies - preformed and de novo - have been reported in the literature to have a negative impact on graft survival, and researchers have been able to further identify subclasses of class II donor-specific antibodies as being the most clinically impactful. Furthermore, there is evidence that donor-specific antibody formation can augment cellular rejection in liver grafts and lead to worsened clinical outcomes. Recent data have shown a higher prevalence of donor-specific antibody formation than previously reported.
SUMMARY: This review explores the most recent literature regarding the clinical impact of both preformed and de-novo donor-specific antibodies and potential management guidelines for patients undergoing liver transplantation. The best practice guidelines for undergoing monitoring for donor-specific antibody formation and protocol biopsies in sensitiz...

Source: Current Opinion in Organ Transplantation - October 28, 2020 Category: Transplant Surgery Authors: Kim SC, Foley DP Tags: Curr Opin Organ Transplant Source Type: research