Abstracts for Publication Only A1-A326
This study assessed relationships between HLA compatibility and rejection rates and complications in pediatric living-related liver transplantation (LRLT).
A total of 84 liver transplantations were performed at our center between December 1988 and October 2003. This study retrospectively investigated data from 14 pediatric LRLTs in which the donor and recipient HLA genotypes were determined preoperatively.
All of the 14 patients (100%) are currently alive with follow-up times of 3-146 months post-transplantation (mean, 35.07±9.07 months). Three patients (21.4%) developed biliary complications (biliary leakage or bile duct stenosis). Three other children (21.4%) developed vascular complications of hepatic artery thrombosis and/or stenosis. Eight patients (57.1%) were diagnosed with acute rejection. Concerning numbers of HLA mismatches in these 8 cases, 1 patient (12.5%) had zero mismatches, 1 (12.5%) had two mismatches, 5 (62.5%) had three mismatches, and 1 (12.5%) had four mismatches. The incidence of acute rejection was not correlated with number of HLA mismatches (all types) (p>0.05), or with number of HLA class 1 (A and B) mismatches (p>0.05); however, it was negatively correlated with number of HLA class 2 (-DR) mismatches (p=0.02). Arterial and biliary complications were not correlated with any of these categories of HLA compatibility.
According to this study, HLA mismatches are not associated with higher incidence of acute rejection or with other complications in this patient group.