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Humoral and cellular rejection after combined liver-kidney transplantation in low immunologic risk recipients

Marangon, Nicola
Venetz, Jean-Pierre
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Published in Transplant International. 2009, vol. 22, no. 2, p. 242-246
Abstract Combined liver-kidney transplantation is considered a low risk for immunologic complication. We report an unusual case of identical ABO liver-kidney recipient without preformed anti-human leukocyte antigen (HLA) antibodies, transplanted across a T- and B-cell-negative cross-match and complicated by early acute humoral and cellular rejection, first in the liver then in the kidney. While analyzing the immunologic complications in our cohort of 12 low-risk combined liver-kidney recipients, only one recipient experienced a rejection episode without detection of anti-HLA antibody over time. Although humoral or cellular rejection is rare after combined kidney-liver transplantation, our data suggest that even in low-risk recipients, the liver does not always systematically protect the kidney from acute rejection. Indeed, the detection of C4d in the liver should be carefully followed after combined liver-kidney transplantation.
Keywords ABO Blood-Group System/immunologyAdultComplement C4b/immunologyFemaleGraft Rejection/drug therapy/immunologyHistocompatibility TestingHumansImmunosuppressive Agents/therapeutic useKidney Transplantation/adverse effects/immunologyLiver Transplantation/adverse effects/immunologyMalePeptide Fragments/immunologyTreatment Outcome
Stable URL https://archive-ouverte.unige.ch/unige:1390
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PMID: 18954373
Research groups Hépatologie chirurgicale (327)
Transplantation Immunologie et Osteoimmunologie (561)
Métastases du foie (657)
Analyse protéomique et Analyse génomique des maladies rénales (659)

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Deposited on : 2009-04-27

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