Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 22;20(1):20251078.
doi: 10.1515/biol-2025-1078. eCollection 2025.

Effects of de novo donor-specific Class I and II antibodies on graft outcomes after liver transplantation: A pilot cohort study

Necip Altundaş  1 , Eda Balkan  2 , Murat Kizilkaya  2 , Nurhak Aksungur  1 , Salih Kara  1 , Elif Demirci  3 , Ercan Korkut  1 , Gürkan Öztürk  1 , Hakan Dursun  4
Affiliations

Effects of de novo donor-specific Class I and II antibodies on graft outcomes after liver transplantation: A pilot cohort study

Necip Altundaş et al. Open Life Sci. .

Abstract

This study investigates the role of donor-specific antibodies (DSAs) in liver transplantation outcomes, focusing on their effects on liver damage. Ninety-four patients who underwent liver transplantation between 2019 and 2024 at Atatürk University were included. DSA testing was performed using the Luminex QIAGEN LifeCodes method. Patient demographic data, laboratory results, clinical conditions, and biopsy findings were analyzed. Disease-specific analyses were conducted for Wilson's disease, autoimmune hepatitis, hepatocellular carcinoma (HCC), and hepatitis B virus (HBV). Due to the limited sample size, larger validation studies are needed, and the impact of the COVID-19 pandemic on the data collection process was considered. At the end of 1 year, persistent DSA had no significant effect on liver damage. However, early DSA positivity, particularly persistence and titration, requires further investigation. In Wilson's disease, two DSA-positive patients (mean fluorescence intensity [MFI] 1,000-1,500) showed no damage. Among autoimmune hepatitis patients, 5 of 19 were DSA positive (MFI 1,700-5,600), with no detected damage. Four HCC patients were DSA positive (MFI 1,300-2,200). Among HBV patients, 12 of 31 were DSA positive, and 5 experienced liver damage. Tacrolimus levels in the third month were statistically associated with bilirubin levels. Prospective studies are needed to further clarify the clinical significance of DSA.

Keywords: chronic allograft dysfunction; donor-specific antibodies; graft rejection mechanisns; liver transplant immunology; molecular biomarkers in transplantation.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: Authors state no conflict of interest.

Figures

Figure 1
Figure 1
Direct bilirubin levels in patients positive for DSAs against Class I and/or Class II HLA.
Figure 2
Figure 2
Class I MFI values in patients positive for DSAs against Class I and/or Class II HLA.
Figure 3
Figure 3
Class II MFI values in patients positive for DSAs against Class I and/or Class II HLA.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Uebayashi EY, Okajima H, Yamamoto M, Ogawa E, Okamoto T, Haga H, et al. The new challenge in pediatric liver transplantation: Chronic antibody-mediated rejection. J Clin Med. 2022 Aug;11(16):2–10. [cited 2024 Aug 26] https://pubmed.ncbi.nlm.nih.gov/36013073/. - PMC - PubMed
    1. O’Leary JG, Cai J, Freeman R, Banuelos N, Hart B, Johnson M, et al. Proposed diagnostic criteria for chronic antibody-mediated rejection in liver allografts. Am J Transplantant. 2016 Feb;16(2):603–14. - PubMed
    1. Feng S, Bucuvalas JC, Demetris AJ, Burrell BE, Spain KM, Kanaparthi S, et al. Evidence of chronic allograft injury in liver biopsies from long-term pediatric recipients of liver transplants. Gastroenterology. 2018 Dec;155(6):1838. [cited 2024 Aug 26] /pmc/articles/PMC6279538/. - PMC - PubMed
    1. Miyagawa-Hayashino A, Yoshizawa A, Uchida Y, Egawa H, Yurugi K, Masuda S, et al. Progressive graft fibrosis and donor-specific human leukocyte antigen antibodies in pediatric late liver allografts. Liver Transpl. 2012 Nov;18(11):1333–42. [cited 2024 Aug 26] https://pubmed.ncbi.nlm.nih.gov/22888064/. - PubMed
    1. Wozniak LJ, Hickey MJ, Venick RS, Vargas JH, Farmer DG, Busuttil RW, et al. Donor-specific HLA antibodies are associated with late allograft dysfunction after pediatric liver transplantation. Transplantation. 2015 Jul;99(7):1416–22. [cited 2024 Aug 26] https://pubmed.ncbi.nlm.nih.gov/26038872/. - PMC - PubMed

LinkOut - more resources