{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:41:54Z","timestamp":1790638914006,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2013,9,1]],"date-time":"2013-09-01T00:00:00Z","timestamp":1377993600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2013,7,26]],"date-time":"2013-07-26T00:00:00Z","timestamp":1374796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Preformed donor-specific human leukocyte antigen antibodies (DSAs) are considered a contraindication to the transplantation of most solid organs other than the liver. Conflicting data currently exist on the importance of preformed DSAs in rejection and patient survival after liver transplantation (LT). To evaluate preformed DSAs in LT, we retrospectively analyzed prospectively collected samples from all adult recipients of primary LT without another organ from January 1, 2000 to May 31, 2009 with a pre-LT sample available (95.8% of the patients). Fourteen percent of the patients had preformed class I and\/or II DSAs with a mean fluorescence intensity (MFI) \u2265 5000. Preformed class I DSAs with an MFI \u2265 5000 remained persistent in only 5% of patients and were not associated with rejection. Preformed class II DSAs with an MFI of 5000 to 10,000 remained persistent in 23% of patients, and this rate increased to 33% for patients whose MFI was \u226510,000 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Preformed class II DSAs in multivariable Cox proportional hazards modeling were associated with an increased risk of early rejection [hazard ratio (HR) = 1.58;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.004]. In addition, multivariate modeling showed that in comparison with no DSAs (MFI &lt; 1000), preformed class I and\/or II DSAs with an MFI \u2265 5000 were independently correlated with the risk of death (HR = 1.51;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02).\n                      <jats:italic toggle=\"yes\">Liver Transpl 19:973\u2013980, 2013<\/jats:italic>\n                      . \u00a9 2013 AASLD.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lt.23687","type":"journal-article","created":{"date-parts":[[2013,6,18]],"date-time":"2013-06-18T07:06:32Z","timestamp":1371539192000},"page":"973-980","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":122,"title":["Preformed class II donor-specific antibodies are associated with an increased risk of early rejection after liver transplantation"],"prefix":"10.1097","volume":"19","author":[{"given":"Jacqueline G.","family":"O'Leary","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Kaneku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda W.","family":"Jennings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nubia","family":"Ba\u00f1uelos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian M.","family":"Susskind","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul I.","family":"Terasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6ran B.","family":"Klintmalm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-6-20250124","first-page":"705","article-title":"The antibody crossmatch in liver transplantation.","volume":"100","author":"Gordon","year":"1986","journal-title":"Surgery"},{"issue":"pt 1","key":"R2-6-20250124","first-page":"396","article-title":"Positive crossmatch in primary human liver allografts under cyclosporine or FK 506 therapy.","volume":"23","author":"Takaya","year":"1991","journal-title":"Transplant Proc"},{"key":"R3-6-20250124","first-page":"1465","article-title":"Significance of a positive crossmatch on outcome in human liver transplantation.","volume":"24","author":"Ogura","year":"1992","journal-title":"Transplant Proc"},{"issue":"pt 2","key":"R4-6-20250124","first-page":"888","article-title":"Humoral rejection associated with antidonor lymphocytotoxic antibodies following liver transplantation.","volume":"25","author":"Manez","year":"1993","journal-title":"Transplant Proc"},{"key":"R5-6-20250124","first-page":"3021","article-title":"The lymphocytotoxic crossmatch in liver transplantation: a clinicopathologic analysis.","volume":"23","author":"Nakamura","year":"1991","journal-title":"Transplant Proc"},{"key":"R6-6-20250124","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1002\/hep.1840160310","article-title":"A clinicopathological study of human liver allograft recipients harboring preformed IgG lymphocytotoxic antibodies.","volume":"16","author":"Demetris","year":"1992","journal-title":"Hepatology"},{"key":"R7-6-20250124","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1097\/00007890-198802000-00026","article-title":"Influence of positive lymphocyte crossmatch and HLA mismatching on vanishing bile duct syndrome in human liver allografts.","volume":"45","author":"Batts","year":"1988","journal-title":"Transplantation"},{"key":"R8-6-20250124","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1002\/hep.1840070311","article-title":"The acute vanishing bile duct syndrome (acute irreversible rejection) after orthotopic liver transplantation.","volume":"7","author":"Ludwig","year":"1987","journal-title":"Hepatology"},{"key":"R9-6-20250124","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1097\/00007890-199202010-00026","article-title":"The adverse impact on liver transplantation of using positive cytotoxic crossmatch donors.","volume":"53","author":"Takaya","year":"1992","journal-title":"Transplantation"},{"key":"R10-6-20250124","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.1399-0012.1989.tb00531.x","article-title":"Evidence for hyperacute rejection of human liver grafts: the case of the canary kidneys.","volume":"3","author":"Starzl","year":"1989","journal-title":"Clin Transplant"},{"key":"R11-6-20250124","doi-asserted-by":"crossref","first-page":"3022","DOI":"10.1111\/j.1600-6143.2006.01554.x","article-title":"Isolated donor specific alloantibodymediated rejection after ABO compatible liver transplantation.","volume":"6","author":"Watson","year":"2006","journal-title":"Am J Transplant"},{"key":"R12-6-20250124","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1002\/lt.23534","article-title":"Progressive graft fibrosis and donorspecific human leukocyte antigen antibodies in pediatric late liver allografts.","volume":"18","author":"MiyagawaHayashino","year":"2012","journal-title":"Liver Transpl"},{"key":"R13-6-20250124","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1002\/lt.23451","article-title":"Donorspecific human leukocyte antigen antibodies of the immunoglobulin G3 subclass are associated with chronic rejection and graft loss after liver transplantation.","volume":"18","author":"Kaneku","year":"2012","journal-title":"Liver Transpl"},{"key":"R14-6-20250124","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1002\/lt.21981","article-title":"Human leukocyte antigen crossmatch testing is important for liver retransplantation.","volume":"16","author":"Goh","year":"2010","journal-title":"Liver Transpl"},{"key":"R15-6-20250124","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1002\/lt.23403","article-title":"Sinusoidal C4d deposits in liver allografts indicate an antibodymediated response: diagnostic considerations in the evaluation of liver allografts.","volume":"18","author":"Kozlowski","year":"2012","journal-title":"Liver Transpl"},{"key":"R16-6-20250124","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1002\/lt.22233","article-title":"Liver allograft antibodymediated rejection with demonstration of sinusoidal C4d staining and circulating donorspecific antibodies.","volume":"17","author":"Kozlowski","year":"2011","journal-title":"Liver Transpl"},{"key":"R17-6-20250124","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1111\/j.1600-6143.2011.03593.x","article-title":"High mean fluorescence intensity donorspecific antiHLA antibodies associated with chronic rejection postliver transplant.","volume":"11","author":"OLeary","year":"2011","journal-title":"Am J Transplant"},{"key":"R18-6-20250124","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/j.1600-6143.2010.03414.x","article-title":"The significance of donorspecific HLA antibodies in rejection and ductopenia development in ABO compatible liver transplantation.","volume":"11","author":"Musat","year":"2011","journal-title":"Am J Transplant"},{"key":"R19-6-20250124","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1002\/lt.21408","article-title":"Preformed antibodies detected by cytotoxic assay or multibead array decrease liver allograft survival: role of human leukocyte antigen compatibility.","volume":"14","author":"CastilloRama","year":"2008","journal-title":"Liver Transpl"},{"key":"R20-6-20250124","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1111\/j.1600-6143.2012.03995.x","article-title":"Prevalence, course and impact of HLA donorspecific antibodies in liver transplantation in the first year.","volume":"12","author":"Taner","year":"2012","journal-title":"Am J Transplant"},{"key":"R21-6-20250124","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1001\/jama.2011.2014","article-title":"Complete immunosuppression withdrawal and subsequent allograft function among pediatric recipients of parental living donor liver transplants.","volume":"307","author":"Feng","year":"2012","journal-title":"JAMA"},{"key":"R22-6-20250124","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1002\/hep.1840210519","article-title":"Immunoglobulin G lymphocytotoxic antibodies in clinical liver transplantation: studies toward further defining their significance.","volume":"21","author":"Manez","year":"1995","journal-title":"Hepatology"},{"key":"R23-6-20250124","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1034\/j.1600-6143.2001.10209.x","article-title":"Susceptibility of liver allografts to high or low concentrations of preformed antibodies as measured by flow cytometry.","volume":"1","author":"Scornik","year":"2001","journal-title":"Am J Transplant"},{"key":"R24-6-20250124","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1111\/j.1600-6143.2009.02985.x","article-title":"Baseline donorspecific antibody levels and outcomes in positive crossmatch kidney transplantation.","volume":"10","author":"Gloor","year":"2010","journal-title":"Am J Transplant"},{"key":"R25-6-20250124","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1111\/j.1600-6143.2008.02441.x","article-title":"Alloantibody levels and acute humoral rejection early after positive crossmatch kidney transplantation.","volume":"8","author":"Burns","year":"2008","journal-title":"Am J Transplant"},{"key":"R26-6-20250124","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1111\/ajt.12147","article-title":"Class II alloantibody and mortality in simultaneous liverkidney transplantation.","volume":"13","author":"OLeary","year":"2013","journal-title":"Am J Transplant"},{"key":"R27-6-20250124","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1111\/j.1600-6143.2011.03467.x","article-title":"Donordirected MHC class I antibody is preferentially cleared from sensitized recipients of combined liverkidney transplants.","volume":"11","author":"Dar","year":"2011","journal-title":"Am J Transplant"},{"key":"R28-6-20250124","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1111\/j.1600-6143.2006.01592.x","article-title":"Successful combined partial auxiliary liver and kidney transplantation in highly sensitized crossmatch positive 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donorspecific HLA antibodies decrease patient and graft survival in liver transplant recipients.","volume":"13","author":"Kaneku","year":"2013","journal-title":"Am J Transplant"},{"key":"R37-6-20250124","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1111\/j.1600-6143.2009.02880.x","article-title":"The influence of induction therapy on graft and patient survival in patients with and without hepatitis C after liver transplantation.","volume":"10","author":"Moonka","year":"2010","journal-title":"Am J Transplant"},{"key":"R38-6-20250124","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1093\/bmb\/lds037","article-title":"Humoral theory of transplantation: some hot topics.","volume":"105","author":"Cai","year":"2013","journal-title":"Br Med Bull"}],"container-title":["Liver 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