Kidney Graft Outcomes in High Immunological Risk Simultaneous Liver-Kidney Transplants.
Journal
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
ISSN: 1527-6473
Titre abrégé: Liver Transpl
Pays: United States
ID NLM: 100909185
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
17
09
2019
accepted:
12
01
2020
pubmed:
6
2
2020
medline:
19
3
2021
entrez:
4
2
2020
Statut:
ppublish
Résumé
Recipients of simultaneous liver-kidney transplantations (SLKTs) have a lower risk of rejection compared with recipients of kidney transplants alone. However, there is disagreement about the impact of pretransplant anti-human leukocyte antigen sensitization on patient and kidney graft survival in the long term. The aim of the study was to evaluate the impact of the recipient immunological risk and comorbidities in renal graft outcomes on SLKT. We reviewed the SLKTs performed in our center from May 1993 until September 2017. Patient and graft survival were analyzed according to the immunological risk, comorbidities, liver and kidney rejection episodes, immunosuppression, and infections. A total of 20 recipients of SLKT were considered in the high immunological risk (HIR) group, and 68 recipients were included in the low immunological risk (LIR) control group. The prevalence of hepatitis C virus infection, second renal transplant, and time on dialysis prior to transplantation were significantly higher in the HIR group. The incidence of acute kidney rejection was higher in the HIR group (P<0.01). However, death-censored kidney graft survival as well as the estimated glomerular filtration rate at follow-up were not different between the 2 groups. Comorbidities, but not the immunological risk, impact negatively on patient survival. Despite the higher incidence of rejection in the HIR SLKT group, longterm renal function and graft survival were similar to the LIR group.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
517-527Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 by the American Association for the Study of Liver Diseases.
Références
Noreen HJ, McKinley DM, Gillingham KJ, Matas AJ, Segall M. Positive remote crossmatch: impact on short-term and long-term outcome in cadaver renal transplantation. Transplantation 2003;75:501-505.
Caro-Oleas JL, Gonzalez-Escribano MF, Gonzalez-Roncero FM, Acevedo-Calado MJ, Cabello-Chaves V, Gentil-Govantes MA, Núñez-Roldán A. Clinical relevance of HLA donor-specific antibodies detected by single antigen assay in kidney transplantation. Nephrol Dial Transplant 2012;27:1231-1238.
Kanter Berga J, Sancho Calabuig A, Gavela Martinez E, Puig Alcaraz N, Beltran Catalan S, Avila Bernabeu A, et al. Pretransplant donor-specific HLA antibodies detected by single antigen bead flow cytometry: risk factors and outcomes after kidney transplantation. Transplant Proc 2012;44:2529-2531.
Malheiro J, Tafulo S, Dias L, Martins LS, Fonseca I, Beirao I, et al. Analysis of preformed donor-specific anti-HLA antibodies characteristics for prediction of antibody-mediated rejection in kidney transplantation. Transplant Immunol 2015;32:66-71.
Redondo-Pachon D, Perez-Saez MJ, Mir M, Gimeno J, Llinas L, Garcia C, et al. Impact of persistent and cleared preformed HLA DSA on kidney transplant outcomes. Hum Immunol 2018;79:424-431.
Terasaki PI. Humoral theory of transplantation. Am J Transplant 2003;3:665-673.
Fidler SJ, Irish AB, Lim W, Ferrari P, Witt CS, Christiansen FT. Pre-transplant donor specific anti-HLA antibody is associated with antibody-mediated rejection, progressive graft dysfunction and patient death. Transplant Immunol 2013;28:148-153.
Marfo K, Ajaimy M, Colovai A, Kayler L, Greenstein S, Lubetzky M, et al. Pretransplant immunologic risk assessment of kidney transplant recipients with donor-specific anti-human leukocyte antigen antibodies. Transplantation 2014;98:1082-1088.
Gordon RD, Fung JJ, Markus B, Fox I, Iwatsuki S, Esquivel CO, et al. The antibody crossmatch in liver transplantation. Surgery 1986;100:705-715.
Mañez R, Kelly RH, Kobayashi M, Takaya S, Bronsther O, Kramer D, et al. Immunoglobulin G lymphocytotoxic antibodies in clinical liver transplantation: studies toward further defining their significance. Hepatology 1995;21:1345-1352.
Hathaway M, Gunson BK, Keogh AC, Briggs D, McMaster P, Neuberger JM. A positive crossmatch in liver transplantation-no effect or inappropriate analysis? A prospective study. Transplantation 1997;64:54-59.
Neumann UP, Lang M, Moldenhauer A, Langrehr JM, Glanemann M, Kahl A, et al. Significance of a T-lymphocytotoxic crossmatch in liver and combined liver-kidney transplantation. Transplantation 2001;71:1163-1168.
Morrissey PE, Gordon F, Shaffer D, Madras PN, Silva P, Sahyoun AI, et al. Combined liver-kidney transplantation in patients with cirrhosis and renal failure: effect of a positive cross-match and benefits of combined transplantation. Liver Transpl Surg 1998;4:363-369.
Flye MW, Duffy BF, Phelan DL, Ratner LE, Mohanakumar T. Protective effects of liver transplantation on a simultaneously transplanted kidney in a highly sensitized patient. Transplantation 1990;50:1051-1054.
Saidman SL, Duquesnoy RJ, Demetris AJ, McCauley J, Ramos H, Mazariegos G, et al. Combined liver-kidney transplantation and the effect of preformed lymphocytotoxic antibodies. Transplant Immunol 1994;2:61-67.
Lang M, Neumann U, Kahl A, Steinmuller T, Settmacher U, Neuhaus P. Long-term outcome of 27 patients after combined liver-kidney transplantation. Transplant Proc 2001;33:1440-1441.
Shapiro R, Zeevi A. Why does combined liver and kidney transplantation confer an immunologic benefit to a kidney? Pediatr Transplant 2010;14:439-440.
Mosconi G, Scolari MP, Feliciangeli G, Zanetti A, Zanelli P, Buscaroli A, et al. Combined liver-kidney transplantation with preformed anti-HLA antibodies: a case report. Transplant Proc 2006;38:1125-1126.
Olausson M, Mjörnstedt L, Nordén G, Rydberg L, Mölne J, Backman L, Friman S. Successful combined partial auxiliary liver and kidney transplantation in highly sensitized cross-match positive recipients. Am J Transplant 2007;7:130-136.
Eid A, Moore SB, Wiesner RH, DeGoey SR, Nielson A, Krom RA. Evidence that the liver does not always protect the kidney from hyperacute rejection in combined liver-kidney transplantation across a positive lymphocyte crossmatch. Transplantation 1990;50:331-334.
Askar M, Schold JD, Eghtesad B, Flechner SM, Kaplan B, Klingman L, et al. Combined liver-kidney transplants: allosensitization and recipient outcomes. Transplantation 2011;91:1286-1292.
O'Leary JG, Gebel HM, Ruiz R, Bray RA, Marr JD, Zhou XJ, et al. Class II alloantibody and mortality in simultaneous liver-kidney transplantation. Am J Transplant 2013;13:954-960.
Castillo-Rama M, Castro MJ, Bernardo I, Meneu-Diaz JC, Elola-Olaso AM, Calleja-Antolin SM, et al. Preformed antibodies detected by cytotoxic assay or multibead array decrease liver allograft survival: role of human leukocyte antigen compatibility. Liver Transpl 2008;14:554-562.
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130:461-470.
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013;48:452-458.
AbdulRahim N, Anderson L, Kotla S, Liu H, Ariyamuthu VK, Ghanta M, et al. Lack of benefit and potential harm of induction therapy in simultaneous liver-kidney transplants. Liver Transpl 2019;25:411-424.
Feng S, Bucuvalas J. Tolerance after liver transplantation: where are we? Liver Transpl 2017;23:1601-1614.
Hibi T, Nishida S, Sageshima J, Levi DM, Ruiz P, Roth D, et al. Excessive immunosuppression as a potential cause of poor survival in simultaneous liver/kidney transplantation for hepatitis C. Transplant Int 2014;27:606-616.
Leca N, Warner P, Bakthavatsalam R, Nelson K, Halldorson J, Rayhill S, et al. Outcomes of simultaneous liver and kidney transplantation in relation to a high level of preformed donor-specific antibodies. Transplantation 2013;96:914-918.
Nilles KM, Krupp J, Lapin B, Sustento-Reodica N, Gallon L, Levitsky J. Incidence and impact of rejection following simultaneous liver-kidney transplantation. J Hepatol 2015;62:340-345.
Taner T, Heimbach JK, Rosen CB, Nyberg SL, Park WD, Stegall MD. Decreased chronic cellular and antibody-mediated injury in the kidney following simultaneous liver-kidney transplantation. Kidney Int 2016;89:909-917.
Thomson AW, Knolle PA. Antigen-presenting cell function in the tolerogenic liver environment. Nat Rev Immunol 2010;10:753-766.
Jenne CN, Kubes P. Immune surveillance by the liver. Nat Immunol 2013;14:996-1006.
Crispe IN. Immune tolerance in liver disease. Hepatology 2014;60:2109-2117.
Racanelli V, Rehermann B. The liver as an immunological organ. Hepatology 2006;43(suppl 1):S54-S62.
Sumimoto R, Kamada N. Specific suppression of allograft rejection by soluble class I antigen and complexes with monoclonal antibody. Transplantation 1990;50:678-682.
Davies HS, Pollard SG, Calne RY. Soluble HLA antigens in the circulation of liver graft recipients. Transplantation 1989;47:524-527.
Créput C, Durrbach A, Menier C, Guettier C, Samuel D, Dausset J, et al. Human leukocyte antigen-G (HLA-G) expression in biliary epithelial cells is associated with allograft acceptance in liver-kidney transplantation. J Hepatol 2003;39:587-594.
Fung J, Makowka L, Tzakis A, Klintmalm G, Duquesnoy R, Gordon R, et al. Combined liver-kidney transplantation: analysis of patients with preformed lymphocytotoxic antibodies. Transplant Proc 1988;20(suppl 1):88-91.
Gugenheim J, Le Thai B, Rouger P, Gigou M, Gane P, Vial MC, et al. Relationship between the liver and lymphocytotoxic alloantibodies in inbred rats. specific absorption by nonparenchymal liver cells. Transplantation 1988;45:474-478.
Sumpter TL, Abe M, Tokita D, Thomson AW. Dendritic cells, the liver, and transplantation. Hepatology 2007;46:2021-2031.
Taner T, Park WD, Stegall MD. Unique molecular changes in kidney allografts after simultaneous liver-kidney compared with solitary kidney transplantation. Kidney Int 2017;91:1193-1202.
Taner T, Gustafson MP, Hansen MJ, Park WD, Bornschlegl S, Dietz AB, Stegall MD. Donor-specific hypo-responsiveness occurs in simultaneous liver-kidney transplant recipients after the first year. Kidney Int 2018;93:1465-1474.
Dar W, Agarwal A, Watkins C, Gebel HM, Bray RA, Kokko KE, et al. Donor-directed MHC class I antibody is preferentially cleared from sensitized recipients of combined liver/kidney transplants. Am J Transplant 2011;11:841-847.