Long-Term Outcomes of Living-Donor Liver Transplantation for XXXX : A Japanese Multicenter Study.

@entity2835 @entity1 @entity205 @entity1140
UNASSIGNED: The factors that influence long-term outcomes after living-donor liver transplantation (LDLT) for @entity2835 ( @entity2835 ) are not well known. Compared with deceased-donor transplantation, LDLT has an increased likelihood of a related donor and a decreased number of human leukocyte antigen (HLA) mismatches. To clarify the effects of donor relatedness and HLA mismatch on the outcomes after LDLT, we retrospectively analyzed 444 Japanese @entity1 . Donors were blood relatives for 332 @entity1 , spouses for 105, and "other" for 7. The number of HLA A-B-DR mismatches was none to two in 141, three in 123, and four to six in 106 @entity1 . The 15-year survival rate was 52.6%, and @entity2835 recurred in 65 @entity1 . Recipient aged 61 years or older, HLA mismatches of four or more (maximum of six), graft:recipient weight ratio less than 0.8, and husband donor were adverse indicators of @entity1 survival. IgM 554   mg/dL or greater, donor-recipient sex mismatch, and initial immunosuppression with @entity205 were significant risks for @entity2835 recurrence, which did not affect @entity1 survival. In subgroup analysis, conversion to @entity205 from @entity1140 within 1 year diminished recurrence. Prospective studies are needed to determine the influence of pregnancy-associated sensitization and to establish an optimal immunosuppressive regimen in LDLT @entity1 .
