The effect of donor against recipient one-way HLA mismatch on liver transplantation outcomes from a multicenter registry analysis

• Published in: Scientific reports Vol. 13; no. 1; p. 22296
• Main Authors: Park, Sunghae, Choi, Young Rok, Joo, Dong Jin, You, Young Kyoung, Kim, Bong-Wan, Nah, Yang Won, Cho, Jai Young, Kim, Tae-Seok, Hong, Geun, Ju, Man Ki, Suh, Suk-Won, Yang, Jae Do, Park, Pyoung Jae, Jeong, Jaehong, Moon, Ju Ik, Kim, Dong-Sik, Rhu, Jinsoo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 15.12.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4020/4021/288; 692/499; Graft rejection; Graft versus host disease; Graft vs Host Disease; Graft-versus-host reaction; Histocompatibility antigen HLA; Histocompatibility Antigens Class I; Histocompatibility Antigens Class II; Histocompatibility Testing; HLA Antigens; Humanities and Social Sciences; Humans; Liver transplantation; Liver Transplantation - adverse effects; Liver transplants; multidisciplinary; Retrospective Studies; Risk factors; Science; Science (multidisciplinary); Survival
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-49178-y

Donor against recipient one-way Human leukocyte antigen (HLA) mismatch (D → R one-way HLA MM) seemed strongly associated with graft-versus-host disease (GVHD). The aim of this study is to investigate the relevance of D → R one-way HLA MM in outcome of liver transplantation (LT). We retrospectively analyzed 2670 patients in Korean Organ Transplantation Registry database between April 2014 and December 2020. The patients were categorized into two groups whether D → R one-way HLA MM or not and evaluated the outcomes of LT between the two groups. 18 patients were found to be D → R one-way HLA MM. The incidence of GVHD (0.3% vs. 22.2%, p  < 0.001) and mortality rate (11.6% vs. 38.9%, p  = 0.003) was much higher in D → R one-way HLA MM group. D → R one-way HLA MM at 3 loci was seemed to be strongly associated with the incidence of GVHD (OR 163.3, p  < 0.001), and found to be the strongest risk factor for patient death (HR 12.75, p  < 0.001). Patients with D → R one-way HLA MM at 3 loci showed significantly lower overall survival ( p  < 0.001) but there were no significant differences in rejection-free survival and death-censored graft survival. D → R one-way HLA MM at 3 loci not only affects the overall survival of LT patients but also the incidence of GVHD.