Living-donor liver transplantation at the University of Tokyo, 1996-2011: the impact of HLA matching and a positive crossmatch on long-term survival and tolerance.

摘要: Objective We analyzed a single center's experience during 16 years of living-donor liver transplantation (LDLT). The impacts HLA mismatches and positive crossmatches on long term outcomes tolerance were evaluated. Methods This study was primary LDLTs consecutive patients from January 1996 to December 2011; re-transplants not included. Long-term survival compared by disease, number mismatches, crossmatches. Demographics complications after between pediatric recipients who achieved clinical operational those did compared. Results One-year graft rates for adult cases 90.4% 91.9%, respectively; the 5-year 83.1% 89.2%, 10-year 79.7% 15-year 65.9% 83.8%, respectively. For grafts that survived more than one year, 88.2% 97.0%, LDLT in 0 1-2 3-4 5-6 79.2%, 86.8%, 77.4%, 69.4%, Although significantly different, lowest with mismatches. Ten-year negative T-cell crossmatch, crossmatch 80.0% 71.1%, 1-year B-cell 90.6% 88.2%, None factors--age donors, donor gender, relationship donors recipients, crossmatches, or mismatches--was different COT non-COT except recipient gender (p = 0.01); cases, there female (88.9%) male (11.1%). Post-transplant complications--acute rejection rate year post-transplant, biliary rate, vascular complication rate--were recipients. Conclusions High long-term both Even higher can be improving early loss. Further studies are necessary determine impact tolerance.