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

Hadaya, Karine; Ferrari-Lacraz, Sylvie; Giostra, Emiliano; Majno, Pietro; Moll, Solange; Rubbia-Brandt, Laura; Marangon, Nicola; Venetz, Jean-Pierre; Bolle, Jean-François; Mentha, Gilles; Villard, Jean

doi:10.1111/j.1432-2277.2008.00775.x

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Title		Humoral and cellular rejection after combined liver-kidney transplantation in low immunologic risk recipients
Authors		Hadaya, Karine Ferrari-Lacraz, Sylvie Giostra, Emiliano Majno, Pietro Moll, Solange Rubbia-Brandt, Laura Marangon, Nicola Venetz, Jean-Pierre Bolle, Jean-François Mentha, Gilles Villard, Jean show all authors [1 - 11]
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/immunology — Adult — Complement C4b/immunology — Female — Graft Rejection/drug therapy/immunology — Histocompatibility Testing — Humans — Immunosuppressive Agents/therapeutic use — Kidney Transplantation/adverse effects/immunology — Liver Transplantation/adverse effects/immunology — Male — Peptide Fragments/immunology — Treatment Outcome
Identifiers		DOI: 10.1111/j.1432-2277.2008.00775.x PMID: 18954373
Full text		Article (Accepted version) (492 Kb) - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie
Research groups		Hépatologie chirurgicale (327) Transplantation Immunologie et Osteoimmunologie (561) Métastases du foie (657) Analyse protéomique et Analyse génomique des maladies rénales (659)
Citation (ISO format)		HADAYA, Karine et al. Humoral and cellular rejection after combined liver-kidney transplantation in low immunologic risk recipients. In: Transplant International, 2009, vol. 22, n° 2, p. 242-246. doi: 10.1111/j.1432-2277.2008.00775.x https://archive-ouverte.unige.ch/unige:1390