1. The dynamic and clinical significance of autoantibodies and immunoglobulins in liver transplant recipients.
- Author
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Stanca CM, Aloman C, Fiel MI, Raja K, Uskudar O, Florman S, and Schiano TD
- Subjects
- Adult, Aged, Autoantibodies immunology, Disease Progression, Female, Follow-Up Studies, Graft Rejection etiology, Graft Survival, Humans, Immunoglobulins immunology, Inflammation etiology, Male, Middle Aged, Prognosis, Recurrence, Risk Factors, Young Adult, Autoantibodies blood, End Stage Liver Disease surgery, Graft Rejection diagnosis, Immunoglobulins blood, Inflammation diagnosis, Liver Transplantation adverse effects, Postoperative Complications
- Abstract
Little is known about autoantibody pattern in liver transplantation (LT). The aim of the study was to examine autoantibodies (AAB) and immunoglobulins in patients with end-stage liver disease before and after LT. Patients with LT who underwent post-LT biopsies between 10/2008 and 8/2011 were enrolled. AAB were assessed at the time of LT and liver biopsy. Demographics, serum immunoglobulins, AAB, and liver histology (explant, post-LT biopsies) were analyzed. Two hundred and twenty patients (M/F 143/77; age at LT 54 (19-73)) were included; AAB and immunoglobulins were evaluated in 76 patients. Length of follow-up from LT was 285 (30-1462) days. Sixty-one percent of patients had hepatitis C (HCV); 83% developed recurrent HCV. A significant decrease in IgG, IgA, IgM (p < 0.001 each), anticardiolipin antibodies IgG and IgM (p = 0.02), and beta-2 microglobulin (p = 0.004) was observed post-LT. HCV patients had higher IgG (p = 0.005), rheumatoid factor (p = 0.044) before LT; elevated IgM was associated with increased inflammation in the explant (p = 0.007). Lower IgG levels and antismooth muscle antibodies were present before LT in a higher percentage in patients who would develop recurrent HCV (p = 0.004, p = 0.077, respectively). In conclusion, AAB change significantly after LT and have a different pattern in HCV. Some immunological markers are associated with HCV recurrence and advanced inflammation on explant., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2016
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