studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 821A
interventional exercise/weight loss trials tailored to LT recipients’
metabolic capacities.
Disclosures:
Josh Levitsky - Consulting: Transplant Genomics Incorporated
The following authors have nothing to disclose: Ajay Singhvi, H. Steven Sadowsky,
Ayelet Cohen, Alysen Demzik, Mary E. Rinella, Lisa B. VanWagner
1236
Retained HLA Class II Donor Specific Antibody after
Liver Transplantation Increases Risk of Acute Cellular
Rejection: A Case Control Study
Mohamed Elfeki 1,3 , Mahmoud El-Bendary 3 , Petrina V. Genco 2 ,
Raghda Farag 3 , Youssef Mosaad 4 , Justin H. Nguyen 1 , Denise M.
Harnois 1 , Surakit Pungpapong 1 ; 1 Transplant, Mayo Clinic, Jacksonville,
FL; 2 Laboratory Medicine and Pathology, Mayo Clinic,
Jacksonville, FL; 3 Tropical Medicine and Hepatology, Mansoura
University, Faculty of Medicine, Mansoura, Egypt; 4 Clinical pathology
and Immunology, Mansoura University, Faculty of Medicine,
Mansoura, Egypt
Background: Liver is an organ that is well-known for its immune
tolerant capacity. Conflicting results regarding liver graft
function and rejection risk affected by pre-transplant positive
lymphocyte cross match (LCM) or post-transplant circulating
donor specific antibody (DSA) have been reported according
to individual institutions. We aimed to evaluate the clinical
significance of positive LCM coupled with positive DSA at time
of and following orthotopic liver transplant (OLT) on outcome
of graft function as regards to biopsy-proven acute cellular
rejection (BPACR) and early allograft dysfunction (EAD). EAD
was defined as the presence of one or more of the following
postoperative laboratory analyses reflective of liver injury and
fuction: bilirubin ≥10mg/dl on day 7, International normalized
ratio ≥1.6 on day 7, and alanine or aspartate aminotransferases
〉2000 IU/L within the first 7 days. Methods: This is a
retrospective case control study of prospectively collected data
from 586 OLT performed at our institution between December
2009 and December 2013. Total of 37 cases with positive
LCM and DSA at the time of OLT were identified. Each case
was matched to two controls (74 controls) based on diagnosis
of liver disease, age and sex of recipients. Results: Majority of
the cases (90%) were females and they had a higher number
of parity when compared to female controls (mean 2.6 vs.
1.7, p=0.003). BPACR occurred significantly more among the
cases than the controls (51% vs. 24%, p=0.006) with an odds
ratio (OR) of 3.28 and 95% confidence interval (CI) of 1.42-
7.57. Higher number of the cases experienced EAD compared
to the controls (22% vs. 9%, p=0.08) with an OR of 2.64 (95%
CI = 0.88-7.96). Despite similar immunosuppressive regimen
per our institutional protocol, the cases who retained HLA class
II DSA post-OLT experienced BPACR more often than the controls
(80% vs. 24%, p