studies

1054A AASLD ABSTRACTS HEPATOLOGY, October, 2015
1734
Dynamics of pediatric liver allograft histological
changes and the role of HLA, non-HLA antibodies
Sharat Varma 3 , Xavier Stephenne 3 , Françoise Smets 3 , Mina
Komuta 1 , Jerome Ambroise 2 , Catherine de Magnée 4 , Dominique
Latinne 5 , Raymond Reding 4 , Etienne M. Sokal 3 ; 1 Department of
anatmopathology, Cliniques universitaires St Luc, Brussels, Belgium;
2 Centre for Applied Molecular Technologies (CTMA), Institut
de Recherche Expérimentale et Clinique (IREC),, Université
Catholique de Louvain (UCL), Brussels, Belgium; 3 Service of Pediatric
Gastroenterology and Hepatology, Cliniques universitaires
St Luc, Brussels, Belgium; 4 Department of Pediatric Surgery and
Transplantation, Cliniques universitaires St Luc, Brussels, Belgium;
5 Clinical Transplant Immunology Department, Cliniques universitaires
St Luc, Brussels, Belgium
Study purpose:HLA and non-HLA antibodies are frequently
seen post liver transplantation(LT) but their impact on the graft is
unknown. We studied the impact of these in transplant recipient
children with minimum confounding factors for causing fibrosis
and histological changes. Methods: Retrospective study of children
transplanted between 2004 - 2014 having known HLA
and non-HLA antibody status and >1 protocol biopsy. Exclusion
criteria were combined organ transplant, re-transplant,
chronic rejection, vascular and biliary complications. Biopsies
were evaluated for bile duct proliferation, portal tract inflammation
and fibrosis by Metavir and Venturi score.Fibrosis rate
was calculated as change in fibrosis score divided by duration
(years) since previous biopsy. HLA antibodies were tested with
solid single bead Luminex assay with MFI>1500 as cut off.
Results: 103 children with 323 biopsies were included. Longer
post LT duration was associated with higher grade of fibrosis
(p 2000 (clinically relevant).
We used the sum of class I and class II antibodies to calculate
total MFI. Results: DSA status in patients with and without ACR
are summarized in Table 1. Sixty-four patients had DSA measured
sometime during follow up. Of these, 37 were positive
for class I or class II at least once. Several patients presented
with both pre-formed and de novo DSA. DSA were not associated
with ACR during follow-up. In those patients with measurable
DSA, MFI >2000 did not correlate with the occurrence
of ACR. Discussion: In this small, single center retrospective
study, 57% of children had measurable pre-formed or de novo
DSA either pre- or post-LT. In spite of this finding, the presence
of DSA at any time during the early follow up period was not
associated with an ACR event. . MFI titer did not predict severity
of rejection among patients who developed ACR.Among
patients who experienced rejection, MFI titers did not correlate
with severity of rejection.Prospective studies are required to
understand better the relationship between DSA and ACR in
pediatric LT.
Table 1
Disclosures:
The following authors have nothing to disclose: Dominique Schluckebier, Laetitia
Marie Petit, Vladimir Cousin, Anne-Laure Rougemont, Jean Villard, Dominique
Belli, Barbara E. Wildhaber, Sylvie Ferrari-Lacraz, Valerie A. McLin