Does Donor-Recipient Genetic Relationship Have an Impact on Outcome of Living Donor Liver Transplantation?

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Abstract

Introduction

Living donor liver transplantation (LDLT) is a valuable option for expanding donor pool, especially in localities where deceased organ harvesting is not allowed. In addition, rejection rates were found to be lower in LDLT, which is attributed to the fact that LDLT is usually performed between relatives. However, the impact of genetic relation on the outcome of LDLT hasn't been studied. In this study, we examined the difference in rejection rates between LDLT from genetically related (GR) donors and genetically unrelated (GUR) donors.

Patients and Methods

All cases that underwent LDLT during the period from May 2004 till May 2014 were included in the study. The study group was divided into 2 groups; LDLT from GR donors and LDLT from GUR donors.

Results

Three-hundred and eight patients were included in the study; 214 from GR donors and 94 from GUR donors. HLA typing wasn’t included in the workup for matching donors and recipients. GUR donors were wives (36; 11.7%), sons in law (7; 2.3%), brothers in law (12; 3.9%), sisters in law (1; 0.3%) and unrelated (38; 12.3%). The incidence of acute rejection in GR group was 17.4%, and in GUR group was 26.3% (p-value= 0.07). However, there was a significant difference in the incidence of chronic rejection between the 2 groups; 7% in GR group and 14.7% in GUR group (p-value= 0.03). In terms of overall survival, there was no significant difference between both groups.

Conclusion

LDLT from GUR donors is not associated with higher incidence of ACR. However, CR was significantly lower when grafts are procured from GR donors. HLA matching may be recommended before LDLT from GUR donors.

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