{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,4]],"date-time":"2024-08-04T02:31:06Z","timestamp":1722738666478},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,3,10]],"date-time":"2012-03-10T00:00:00Z","timestamp":1331337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/purpose<\/jats:title><jats:p>The clinical features and perioperative management of liver transplant recipients who are already sensitized against human leukocyte antigen (HLA) prior to transplantation are not yet clear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Medical records of living donor liver transplant recipients were reviewed and clinical features of the patients possessing anti\u2010HLA antibodies were studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 470 consecutive living donor liver transplant recipients, 6 patients (1.3%) had preformed anti\u2010HLA antibodies. A review of the postoperative courses of these patients revealed that the problems included platelet transfusion refractoriness (PTR) due to immune\u2010mediated destruction of platelet and thrombotic microangiopathy (TMA). PTR was observed in patients with anti\u2010HLA class I antibodies and only HLA\u2010matched platelet concentrate (HLA\u2010matched PC) relieved thrombocytopenia. Intravenous gammaglobulin had an additive effect to HLA\u2010matched PC in some cases, and platelet transfusion from close relatives might be a substitute for HLA\u2010matched PC in life\u2010threatening situations. Although the etiology of TMA is unremarkable, the incidence was high (67%, 4\/6) compared with that in patients who were not sensitized against HLA (5.6%, 26\/464;<jats:italic>p<\/jats:italic> &lt; 0.01). Of the four patients, three were complicated with late\u2010onset TMA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Considering these clinical features, careful preparation and postoperative management are needed for liver transplant candidates with anti\u2010HLA antibodies.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00534-012-0511-0","type":"journal-article","created":{"date-parts":[[2012,3,9]],"date-time":"2012-03-09T10:45:17Z","timestamp":1331289917000},"page":"279-285","source":"Crossref","is-referenced-by-count":5,"title":["Living donor liver transplantation for patients immunized against human leukocyte antigen"],"prefix":"10.1002","volume":"20","author":[{"given":"Junichi","family":"Shindoh","sequence":"first","affiliation":[{"name":"Division of Artificial Organ and Transplantation, Department of Surgery University of Tokyo  7\u20103\u20101 Hongo, Bunkyo\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiko","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Division of Artificial Organ and Transplantation, Department of Surgery University of Tokyo  7\u20103\u20101 Hongo, Bunkyo\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumihito","family":"Tamura","sequence":"additional","affiliation":[{"name":"Division of Artificial Organ and Transplantation, Department of Surgery University of Tokyo  7\u20103\u20101 Hongo, Bunkyo\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Division of Artificial Organ and Transplantation, Department of Surgery University of Tokyo  7\u20103\u20101 Hongo, Bunkyo\u2010ku Tokyo 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