Diagnosis and therapy of antibody-mediated rejections in pediatrics after living donor liver transplantation
10.3760/cma.j.issn.0254-1785.2018.08.008
- VernacularTitle:儿童亲属活体肝移植术后抗体介导的排斥反应的诊断与治疗
- Author:
Kai WANG
1
;
Wei GAO
;
Nan MA
;
Xingchu MENG
;
Wei ZHANG
;
Chao SUN
;
Chong DONG
;
Bin WU
;
Chao HAN
;
Hong QIN
;
Zhen WANG
Author Information
1. 300192,天津市第一中心医院移植外科 天津市器官移植重点实验室 天津市器官移植临床医学研究中心
- Keywords:
Living donor;
Pediatrics;
Liver transplantation;
Donor specific antibody;
Graft rejection;
Antibody mediated
- From:
Chinese Journal of Organ Transplantation
2018;39(8):482-486
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summary the diagnosis and therapy of antibody-mediated rejection (AMR) caused by donor specific antibody (DSA) in pediatrics after living donor liver transplantation.Methods The clinical data of total 4 pediatric recipients with biliary atresia after liver transplantation were retrospectively analyzed.Liver biopsy was performed and HLA antibodies were detected by Luminex.The abnormal graft function was found.Results The concentrations of immunosuppressant were very low pre-AMR-diagnosed.DSA was detected in total 4 patients with the most DSA at HLA-Ⅱ antibodies.Staining of C4d was positive in liver biopsies in 3 of 4 recipients.The patients were gvien plasmapheresis,intravenous immunoglobulin,mycophenolate mofetil and rituximab postdiagnosis.However,only 1 patient was cured with normal graft function and negative DSA.The rest of patients received re-transplantation because of ineffective treatment and showed a well graft function during the follow-up period.Conclusion AMR induced by DSA was rare complaint after pediatric liver transplantation,with serious consequence and poor prognosis.AMR in some patients can be cured by conservative therapies as being diagnosed definitely.However,re-transplantation was oneof the valid therapies to AMR.
