HLA-DRB1 donor-recipient mismatch affects the outcome of hepatitis C disease recurrence after liver transplantation

Luca Saverio Belli, Patrizia Burra, Francesca Poli, Alberto Battista Alberti, Enrico Silini, Claudio Zavaglia, Stefano Fagiuoli, Daniela Prando, Alejandro Espadas De Arias, Sara Boninsegna, Carmine Tinelli, Mario Scalamogna, Luciano De Carlis, Giovambattista Pinzello

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Abstract

Background & Aims: This study extends our previously reported observations that various immunological factors are associated with the occurrence of histologically proven recurrent hepatitis C. The two specific issues investigated were to confirm the associations of MHC alleles and donor/recipient mismatch with the occurrence of recurrent hepatitis C in an independent cohort of newly transplanted patients and to look for immunologic and nonimmunologic variables affecting the severity of the recurrent disease. Methods: Two separate cohorts of consecutive patients were studied: a look-back cohort (LC) of 120 patients and a cohort for studying the disease progression (CSDP) of 190 patients. Protocol liver biopsies were obtained at least 1, 3, 5, 7, and 10 years after liver transplantation (LT). Results: A fully mismatched donor/recipient pair at the DRB1 locus was confirmed to be associated with both the recurrence of histologic hepatitis in the LC (59% vs 23%, P = .0002) and its progression beyond stage 3 in the CSPD (71.4% vs 39.3%, P = .0003). Relevant immunologic and nonimmunologic variables were included into a multivariate Cox proportional model and three variables, namely, donor age, full HLA-DRB1 donor-recipient mismatch, and HLA B14, resulted in independent risk factors for the development of severe fibrosis. Conclusion: This study provides evidence that DRB1 donor-recipient mismatch affects both the occurrence and progression of recurrent hepatitis C disease. This information is clinically relevant as it may help to better allocate organs and to recognize patients at risk for progression so that specific interventions can be implemented.

Original languageEnglish
Pages (from-to)695-702
Number of pages8
JournalGastroenterology
Volume130
Issue number3
DOIs
Publication statusPublished - Mar 2006

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ASJC Scopus subject areas

  • Gastroenterology

Cite this

Belli, L. S., Burra, P., Poli, F., Alberti, A. B., Silini, E., Zavaglia, C., Fagiuoli, S., Prando, D., Espadas De Arias, A., Boninsegna, S., Tinelli, C., Scalamogna, M., De Carlis, L., & Pinzello, G. (2006). HLA-DRB1 donor-recipient mismatch affects the outcome of hepatitis C disease recurrence after liver transplantation. Gastroenterology, 130(3), 695-702. https://doi.org/10.1053/j.gastro.2005.11.013