Article: article from journal or magazin.
Humoral and cellular rejection after combined liver-kidney transplantation in low immunologic risk recipients.
Publication types: Case Reports
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.
ABO Blood-Group System/immunology, Adult, Complement C4b/immunology, Female, Graft Rejection/drug therapy, Graft Rejection/immunology, Histocompatibility Testing, Humans, Immunosuppressive Agents/therapeutic use, Kidney Transplantation/adverse effects, Kidney Transplantation/immunology, Liver Transplantation/adverse effects, Liver Transplantation/immunology, Male, Peptide Fragments/immunology, Treatment Outcome
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