Preformed donor‐specific antibodies do not affect the 1‐year allograft survival in living donor liver transplantation

Abstract The effect of preformed donor‐specific antibodies ( DSA s) on liver transplantation ( LT ) remains unclear, especially in the field of living donor LT ( LDLT ). Herein, we evaluated the prevalence of preformed DSA s and their effect on graft outcome in LDLT in the first year following surgery. Using the Luminex ® Single Antigen assay, we analyzed the preoperative sera of 61 adult LDLT recipients between 2014 and 2015. Clinical outcomes and pathologic findings including complement component 4d (C4d) expression in the first year after LT were retrospectively reviewed. Regardless of the class of DSA , DSA s with mean fluorescence intensity ( MFI ) ≥1000 were defined as positive and preformed DSA with MFI ≥5000 was defined as strongly positive. Fifteen patients (24.6%) had preformed DSA s, and 8 patients (13.1%) showed strongly positive preformed DSA s. Among 15 DSA positive patients, 2 (13.3%) showed persistent DSA s after LDLT . No de novo DSA s were noted in patients without preformed DSA s. Preformed DSA s were not related to graft dysfunction, laboratory values, or C4d expression or other pathologic findings in the first year of LDLT . In conclusion, preformed DSA s persisted during follow‐up in 13.3% of cases and did not have adverse effect on histologic or clinical outcomes in the first year of LDLT .