{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T13:28:51Z","timestamp":1781530131808,"version":"3.54.1"},"reference-count":42,"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":[[2013,8,18]],"date-time":"2013-08-18T00:00:00Z","timestamp":1376784000000},"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>A positive crossmatch has been associated with increased risk in liver transplantation. To study the clinical significance of preformed donor-specific human leukocyte antigen antibodies (DSAs) in liver transplantation, we reviewed patients who underwent liver transplantation with a strongly positive flow cytometry crossmatch. DSAs were evaluated with a Luminex solid phase assay. The complement-fixing ability of DSAs was tested with a complement component 1q (C1q) assay. Using an assay correlation between complement-dependent cytotoxicity crossmatch, flow cytometry crossmatch, and DSA results, we reviewed the effects of DSAs on the outcomes of our patients as well as reported cases in the literature. Five of 69 liver recipients had a strongly positive crossmatch: 4 had a positive T cell crossmatch [median channel shift (MCS) = 383.5 \u00b1 38.9], and 5 had a positive B cell crossmatch (MCS = 408.8 \u00b1 52.3). The DSAs were class I only in 1 patient, class I and II in 3 patients, and class II only in 1 patient. Cholestasis, acute rejection, or both were observed in 3 of the 4 patients with a positive T cell crossmatch with an MCS approximately greater than 300. The C1q assay was positive for 3 patients. Two had either persistent cholestasis or early acute rejection. One patient who was treated with preemptive intravenous immunoglobulin had an unremarkable outcome despite a positive C1q result. One of the 2 patients with a negative C1q assay experienced persistent cholestasis and early and recurrent acute rejection; the other had an unremarkable outcome. None of the patients died or lost a graft within the first year of transplantation. Our study suggests that human leukocyte antigen antibody screening, flow cytometry crossmatch MCS levels, DSA mean fluorescent intensity levels, and C1q assays may be useful in assessing the risk of antibody-mediated rejection and timely interventions in liver transplantation. <jats:italic toggle=\"yes\">Liver Transpl 19:1001\u20131010, 2013<\/jats:italic>. \u00a9 2013 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.23694","type":"journal-article","created":{"date-parts":[[2013,6,24]],"date-time":"2013-06-24T19:12:41Z","timestamp":1372101161000},"page":"1001-1010","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["Liver transplantation with a strongly positive crossmatch: Case study and literature review"],"prefix":"10.1097","volume":"19","author":[{"given":"Garrett R.","family":"Leonard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Shike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadahiro","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine L.","family":"Gaspari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca M.","family":"Ruggiero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riaz A.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas R.","family":"Riley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakiyah","family":"Kadry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-10-20250124","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.surg.2009.11.022","article-title":"Does a positive lymphocyte crossmatch contraindicate livingdonor liver transplantation?","volume":"147","author":"Hori","year":"2010","journal-title":"Surgery"},{"key":"R2-10-20250124","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1038\/modpathol.3800784","article-title":"Significance of C4d staining in ABOidenticalcompatible liver transplantation.","volume":"20","author":"Sakashita","year":"2007","journal-title":"Mod Pathol"},{"key":"R3-10-20250124","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.humimm.2009.04.009","article-title":"Analysis of positive kidney, 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An assessment by cytotoxicity and flow cytometry.","volume":"60","author":"Donaldson","year":"1995","journal-title":"Transplantation"},{"key":"R41-10-20250124","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/S0168-8278(96)80166-8","article-title":"Influence of antiHLA antibodies and positive Tlymphocytotoxic crossmatch on survival and graft rejection in human liver transplantation.","volume":"24","author":"Charco","year":"1996","journal-title":"J Hepatol"},{"key":"R42-10-20250124","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1002\/lt.500040411","article-title":"The effect of a positive Tlymphocytotoxic crossmatch on hepatic allograft survival and rejection.","volume":"4","author":"Bathgate","year":"1998","journal-title":"Liver Transpl Surg"},{"key":"R43-10-20250124","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1097\/01.tp.0000251361.12249.a1","article-title":"Antidonor antibody in patients receiving ABOidentical and HLAmismatched living donor liver transplants: effect on survival.","volume":"83","author":"Ashihara","year":"2007","journal-title":"Transplantation"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.23694","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.23694","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201309000-00010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T17:28:16Z","timestamp":1737739696000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201309000-00010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9]]},"references-count":42,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2013]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.23694","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2013,9]]}}}