J Korean Surg Soc.  2013 Apr;84(4):245-251. 10.4174/jkss.2013.84.4.245.

The effect of a positive T-lymphocytotoxic crossmatch on clinical outcomes in adult-to-adult living donor liver transplantation

• Kim YK
• Kim SH
• Moon IS
• Han SS
• Cho SY
• You T
• Park SJ

• KMID: 2212470
• DOI: http://doi.org/10.4174/jkss.2013.84.4.245

Abstract

PURPOSE
There is controversy concerning the effect of a positive T-lymphocytotoxic crossmatch (TLC) on clinical outcomes in adult living donor liver transplantation (LDLT). The aim of this study was to investigate the effect of TLC on clinical outcomes in LDLT and to determine how long a pretransplant positive TLC continues after liver transplantation (LT).
METHODS
Between January 2005 and June 2010, 219 patients underwent adult LDLT at National Cancer Center. The TLC test was routinely performed before LDLT. TLC test results were positive in 8 patients (3.7%). Patients were divided into 2 groups according to the result of TLC: positive TLC (n = 8) and negative TLC (n = 211) groups. All patients with a pretransplant positive TLC (n = 6) underwent a TLC test every week until negative conversion of TLC, except 2 patients who refused to receive the TLC test.
RESULTS
Acute cellular rejection, surgical complications and patient or graft survival were not significantly different between both groups. All patients with a positive TLC (n = 6) had a posttransplant negative TLC. The median time to negative conversion of TLC was 1.5 weeks (range, 1 to 3 weeks).
CONCLUSION
A pretransplant positive TLC does not affect clinical outcomes in adult LDLT. Moreover, T-lymphocytotoxic cross-reactivity disappeared within 3 weeks (range, 1 to 3 weeks) after LT.

Keyword

Living donor liver transplantation; Crossmatch; Acute rejection; Survival

MeSH Terms

Adult
Graft Survival
Humans
Liver
Liver Transplantation
Living Donors
Rejection (Psychology)

Figure

• 

  Fig. 1 Kaplan-Meier patient survival curves of 219 patients underwent adult-to-adult living donor liver transplantation according to their pretransplant T-lymphocytotoxic crossmatch (TLC) results. The 1- and 3-year patient survival rates were 85.7% and 85.7%, respectively, in the positive crossmatch group (n = 211, solid line), while they were 94.6% and 85.6%, respectively, in the negative crossmatch group (n = 8, dashed line); the difference between the groups was not statistically significant (P = 0.68).

• 

  Fig. 2 Kaplan-Meier graft survival curves of 219 patients underwent adult-to-adult living donor liver transplantation according to their pretransplant T-lymphocytotoxic crossmatch (TLC) results. The 1- and 3-year patient survival rates were 85.7% and 85.7%, respectively, in the positive crossmatch group (n = 211, solid line), while they were 93.9% and 83.7%, respectively, in the negative crossmatch group (n = 8, dashed line); the difference between the groups was not statistically significant (P = 0.73).

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