Analysis of Relationship between Positive T Lymphocytotoxic and/or B Lympocytotoxic Cross- Match and Acute Rejection in Adult-to-Adult Living Donor Liver Transplantation

Kim, Yeon Dae; Lee, Sung Gyu; Hwang, Shin; Park, Kwang Min; Kim, Ki Hun; Ahn, Chul Soo; Moon, Deok Bog; Ha, Tae Young; Kim, Keon Kuk

Abstract

PURPOSE
The influences of lymphocytotoxic cross-match on survival or acute rejection after adult-to-adult living donor liver transplantation (LDLT) have not been fully studied and there have been some arguments about its influence. In this study, we retrospectively investigated the influence of lymphocytotoxic cross-match in LDLT and assessed the survival of recipients and the incidence of acute rejection.
METHODS
142 adult-to-adult LDLT were performed in adult patients in our institution between January 2003 and December 2003. Among them, HLA cross-matching tests were done in 78 cases and we analyzed their data of HLA cross-match. Recipients were 62 males and 16 females, and their mean age was 50 7 years. Most of the donors were genetically related to the recipients. Lymphocyototxic cross-match was performed according to the standard National Institutes of Health technique. The cross-match test was interpreted as positive when more than 20% of the donor lymphocytes were killed by the recipient serum, Acute cellular rejection was defined as a biopsy-proven episode and graded according to the Banff schema.
RESULTS
The results of positive T and/or B cell cross-match observed in only 5 cases (6.4%). In this series, there were episodes of acute rejection in 10 recipients (13.6%) after 1~9 months, but all of 10 had revealed negative results of T and B cell cross-match. Additionally, the results of positive T and/or B cell cross-match did not change the incidence of acute rejection. All of the recipients undergone acute rejection were treated successfully using steroid bolus therapy and survive to date.
CONCLUSION
According to our preliminary results, positive T and/or B cell cross-match did not give significant impact upon either the incidence of acute rejection or the survival rate in our series with 13% incidence of acute rejection and 5% mortality.