Donor Specific Antibody Negative Antibody-Mediated Rejection after ABO Incompatible Liver Transplantation.
10.4285/jkstn.2018.32.4.108
- Author:
Boram LEE
1
;
Soomin AHN
;
Haeryoung KIM
;
Ho Seong HAN
;
Yoo Seok YOON
;
Jai Young CHO
;
Young Rok CHOI
Author Information
1. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. choiyoungrok@gmail.com
- Publication Type:Case Report
- Keywords:
Liver transplantation;
Antibody-dependent cell cytotoxicity;
Rejection;
Living donors;
HLA antigens
- MeSH:
Allografts;
Antibody-Dependent Cell Cytotoxicity;
B-Lymphocytes;
Biopsy;
Carcinoma, Hepatocellular;
Diagnosis;
Fibrosis;
Hand;
Hepatitis B virus;
HLA Antigens;
Humans;
Liver Transplantation*;
Liver*;
Living Donors;
Middle Aged;
Tissue Donors*
- From:The Journal of the Korean Society for Transplantation
2018;32(4):108-112
- CountryRepublic of Korea
- Language:English
-
Abstract:
Antibody-mediated rejection (AMR) is a major complication after ABO-incompatible liver transplantation. According to the 2016 Banff Working Group on Liver Allograft Criteria for the diagnosis of acute AMR, a positive serum donor specific antibody (DSA) is needed. On the other hand, the clinical significance of the histological findings of AMR in the absence of DSA is unclear. This paper describes a 57-year-old man (blood type, O+) who suffered from hepatitis B virus cirrhosis with hepatocellular carcinoma. Pre-operative DSA and cross-matching were negative. After transplantation, despite the improvement of the liver function, acute AMR was observed in the protocol biopsy on postoperative day 7; the cluster of differentiation 19+ (CD19+) count was 0% and anti-ABO antibody titers were 1:2. This paper presents the allograft injury like AMR in the absence of DSA after ABOi living donor liver transplantation with low titers of anti-ABO antibody and depleted serum CD19+ B cells.
