Clinical significance of donor-specific human leukocyte antigen antibodies in liver transplantation

Table 1 Association of graft fibrosis and concomitant anti-human leukocyte antigen class II donor-specific anti-human leukocyte antigen antibodies

Ref.	No. of patients	Positive for HLA Abs	Transplant type	Follow-up. median (yr)	Time detection DSA	Method detection DSA	MFI
Miyagawa-Hayashino et al[78]	79	32	LD	11	After LT	SAB	> 5000
Salah et al[58]	114	5	LD	2	After LT	SAB	> 5000
O´Leary et al[60]	507	46	DD	6.4	Pre and after LT	SAB	> 5000
Grabhorn et al[72]	19	16	LD + DD	4.5	After LT	SAB	> 5000
Iacob et al[79]	174	34	LD + DD	ND	After LT	SAB	> 5000

HLA: Human leukocyte antigen; DSA: Donor-specific anti-HLA antibodies; SAB: Single-antigen-bead; MFI: Mean fluorescence intensity; LT: Liver transplant.

Table 2 Diagnostic criteria of acute antibody-mediated rejection in liver transplantation

The presence of DSA in serum

Histopathologic evidence of diffuse microvascular endothelial cell injury and microvasculitis

Strong and diffuse C4d positivity in tissue1

Reasonable exclusion of other causes of injury that might result in similar findings

¹Diffuse portal microvascular positivity in formalin-fixed, paraffin-embedded samples (although detection of C4d is more sensitive in fresh tissue) is emerging as most strongly correlated with donor-specific anti-HLA antibodies-induced injury. DSA: Donor-specific anti-HLA antibodies.