Significance of auto-antibodies in living donor liver transplantation: A scoping review
10.52604/alt.25.0010
- Author:
Bochao JIANG
;
Chanda Kendra HO
;
Thinesh Lee KRISHNAMOORTHY
- Publication Type:Original Article
- From:
Annals of Liver Transplantation
2025;5(2):98-106
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Living donor liver transplantation (LDLT) is lifesaving for patients with end-stage liver disease, especially where cadaveric grafts are limited. Some centers may exclude potential donors with positive auto-antibodies (AAbs) due to concerns of autoimmune hepatitis (AIH) and jeopardizing donor safety. This scoping review evaluates the natural history and clinical significance of AAbs in LDLT donors.
Methods:A comprehensive search of PubMed, Embase, and Cochrane Library was conducted, following PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines and under consultation with an experienced librarian. English articles published from 2000 to 2024 were included. Two reviewers independently assessed eligibility and extracted relevant data on study characteristics, AAb types, donor demographics, follow-up duration, and clinical outcomes.
Results:Of 1,067 screened studies, 22 were relevant (20 focused on donor outcomes and protocols, 2 on AAb screening in donor selection). Only one study specifically mentioned that a normal autoimmune workup is necessary for donor eligibility. Regarding the natural history of AAbs, 10 studies were relevant, including 2 reviews on prognosis. No conclusive evidence linked AAbs to increased AIH risk in donors with normal liver function.
Conclusion:Significant knowledge gaps exist regarding AAbs in donor safety and their natural history. Donor screening practices varied widely across institutions.AAbs are neither routinely screened nor considered an exclusion criterion in most centres. In asymptomatic individuals with normal liver function and AAbs, there does not appear to be an elevated risk for developing AIH. This review maps existing gaps in literature and highlights areas for future research.
