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. 2022 Sep 27;14(9):1757-1766.
doi: 10.4254/wjh.v14.i9.1757.

Positive autoantibodies in living liver donors

Joyce Loh  1 , Koji Hashimoto  2 , Choon Hyuck David Kwon  2 , Masato Fujiki  2 , Jamak Modaresi Esfeh  3
Affiliations

Positive autoantibodies in living liver donors

Joyce Loh et al. World J Hepatol. .

Abstract

Background: There is a nationwide shortage of organs available for liver transplantation. Living donors help meet this growing demand. Not uncommonly, donors will have positive autoantibodies. However, it is unclear whether donor positive autoantibodies are correlated with worse outcomes following living liver donor transplantations.

Aim: To analyze the significance of positive autoantibodies in donors on post-transplant outcomes in recipients.

Methods: We performed a retrospective review of living liver donors who had undergone liver transplantation between January 1, 2012 and August 31, 2021. Demographic characteristics and pre-transplant data including antinuclear antibodies (ANA) and anti-smooth muscle antibody titers were collected in donors. Outcomes of interest were post-transplantation complications including mortality, biliary strictures, biliary leaks, infection, and rejection. Pediatric recipients and donors without measured pre-transplant autoantibody serologies were excluded from this study.

Results: 172 living donor liver transplantations were performed during the study period, of which 115 patients met inclusion criteria. 37 (32%) living donors were autoantibody-positive with a median ANA titer of 1:160 (range 1:80 to 1:1280) and median anti-SMA titer of 1:40 (range 1:20 to 1:160). There were no significant differences in baseline demographics between the autoantibody positive and negative donors. Post-transplantation rates of death (P value = 1), infections (P value = 0.66), and overall rates of complications (P value = 0.52) were similar between the autoantibody positive and negative groups. Higher incidences of anastomotic strictures and rejection were observed in the autoantibody positive group; however, these differences were not statistically significant (P value = 0.07 and P value = 0.30 respectively).

Conclusion: Isolated pre-transplant autoantibody positivity is not correlated to worse post-transplant outcomes in living liver donor transplants.

Keywords: Anti-smooth muscle antibody; Antinuclear antibodies; Liver transplantation; Transplant donors; Treatment outcome.

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Conflict of interest statement

Conflict-of-interest statement: We have no financial relationships to disclose.

Figures

Figure 1
Figure 1
Exclusion and inclusion criteria.
Figure 2
Figure 2
Histogram of individual antinuclear antibodies and anti-smooth muscle antibody titers (Three donors had both a positive antinuclear antibodies and anti-smooth muscle antibody and are not included in the above histogram). ANA: antinuclear antibodies; ASMA: Anti-smooth muscle antibody.
See this image and copyright information in PMC

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