Titre :

Treatment of donor-specific anti-HLA antibodies-mediated rejection after liver transplantation: A French nationwide retrospective study.

Auteur(s) :

Dumortier, Jerome [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Conti, Filomena [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Hiriart, Jean-Baptiste [Auteur]
Hôpital Haut-Lévêque [CHU Bordeaux]
Dharancy, Sebastien [Auteur]
Hôpital Claude Huriez [Lille]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Duvoux, Christophe [Auteur]
Hôpital Henri Mondor
Besch, Camille [Auteur]
Hôpital de Hautepierre [Strasbourg]
Houssel-Debry, Pauline [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Latournerie, Marianne [Auteur]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Chermak, Faiza [Auteur]
Hôpital Haut-Lévêque [CHU Bordeaux]
Meszaros, Magdalena [Auteur]
Hôpital Saint Eloi [CHU Montpellier]
Pageaux, Georges-Philippe [Auteur]
Hôpital Saint Eloi [CHU Montpellier]
Radenne, Sylvie [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Boillot, Olivier [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Hardwigsen, Jean [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Kounis, Ilias [Auteur]
Hôpital Paul Brousse
Kamar, Nassim [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Saliba, Faouzi [Auteur]
Hôpital Paul Brousse
Erard, Domitille [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Del Bello, Arnaud [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]

Titre de la revue :

Liver Transplantation

Nom court de la revue :

Liver Transpl

Date de publication :

2023-06-29

ISSN :

1527-6473

Résumé en anglais : [en]

The deleterious effect of donor-specific anti-HLA antibodies (DSA) after liver transplantation (LT) has been increasingly recognized during the past decade. Antibody-mediated rejection (AMR) represents a rare but severe ...
Lire la suite >The deleterious effect of donor-specific anti-HLA antibodies (DSA) after liver transplantation (LT) has been increasingly recognized during the past decade. Antibody-mediated rejection (AMR) represents a rare but severe complication in the presence of DSA. However, little is known concerning the treatment of AMR after LT. The nationwide French study aimed to describe LT recipients who received specific treatment of AMR. We performed a multicenter retrospective study on 44 patients who were treated with B-cell targeting agents from January 2008 to December 2020. Median patient age at the time of AMR treatment was 51.6 years (range: 17.9–68.0). AMR was classified as acute (n = 19) or chronic (n = 25). The diagnosis of AMR was made after a median time of 16.8 months (range: 0.4–274.2) after LT. The main therapeutic combination was plasma exchange/rituximab/IVIG (n = 25, 56.8%). The median follow-up after the treatment of AMR was 32 months (range: 1–115). After the treatment, 1-, 5- and 10-year patient and graft survivals were 77%, 55.9%, and 55.9%, and 69.5%, 47.0%, and 47.0%, respectively. Initial total bilirubin (Q1–Q3 vs. Q4) was significantly associated with patient survival (log-rank test, p = 0.005) and graft survival (log-rank test, p = 0.002). After a median follow-up of 21 months (range: 12–107), DSA became undetectable in 15/38 patients (39.5%) with available DSA monitoring. In conclusion, specific treatment of AMR in LT recipients has slowly emerged in France during the past decade and has probably been considered in the most severe patients; this explains the global poor outcome, even if the outcome was favorable in some cases.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Date de dépôt :

2024-02-03T22:30:55Z
2024-03-12T12:33:51Z