NCT03094728

Role of Human Leukocyte Antigen Matching in Liver Transplantation and Its Relation to Outcomes

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 24 (actual)
• Sponsor: Ain Shams University · Academic / Other
• Sex: All
• Age: 18 Years – 65 Years
• Healthy volunteers: —

Summary

The study aimed to assess HLA compatibility, HLA antibodies and cross matching in liver transplantation recipients and their relation to acute rejection, CMV infection, and recurrence of HCV.

Detailed description

This was a cohort study conducted in patients who had undergone LDLT between January 2015 and January 2016 at in Ain Shams Center for Organ Transplantation (ASCOT) . HLA Typing and Mismatch: Preoperative blood samples from all recipients and donors were collected. The serological tissue typing for HLA was performed by a SSP-PCR (sequence-specific- primer). HLA-A, HLA- B, and HLA-DR loci were examined and used to calculate mismatch scores. The locus-specific type of HLA mismatch, as well as the degree of HLA mismatch, was then assessed. For each locus individually, the mismatch number was scored as 0, 1, or 2, on the basis of the number of donor alleles not shared with the respective recipient. Each patient was assigned an overall total score depending on the total number of mismatches at the 3 loci, ranging from 0 (no mismatches at any loci) to 6 (mismatches at all loci) Cross matching (total and autocross): Crossmatch involves placing recipient serum (potentially containing donor-specific anti-HLA antibodies) onto donor lymphocytes (containing HLA antigens).A cytotoxic reaction (deemed 'positive') suggests the presence of preformed DSAbs (donor specific antibodies). Autoantibodies are generally IgM rather than IgG antibodies. To establish if autoantibodies are responsible for the result an auto-crossmatch should be performed. In this assay, recipient serum is crossmatched against recipient (rather than donor) lymphocytes. Second, the original crossmatch should be repeated with the addition of the agent Dithiothreitol (DTT). DTT reduces the disulfide bonds in IgM thereby preventing IgM antibodies from generating a positive result. IgM antibodies are generally regarded as having no pathological significance in transplantation.

Conditions

• Liver Transplantation

Interventions

Type	Name	Description
DIAGNOSTIC_TEST	HLA cross matching	HLA Typing and Mismatch Cross matching (total and autocross): Cross match involves placing recipient serum onto donor lymphocytes and a cytotoxic reaction (deemed 'positive') suggests the presence of preformed donor specific antibodies (DSAs),Second, the original crossmatch should be repeated with the addition of the agent Dithiothreitol (DTT). DTT reduces the disulfide bonds in IgM thereby preventing IgM antibodies from generating a positive result.

Timeline

• Start date: 2015-01-01
• Primary completion: 2016-01-01
• Completion: 2016-06-01
• First posted: 2017-03-29
• Last updated: 2017-03-29