Loh J, Hashimoto K, Kwon CHD, Fujiki M, Modaresi Esfeh J. Positive autoantibodies in living liver donors. World J Hepatol 2022; 14(9): 1757-1766 [PMID: 36185722 DOI: 10.4254/wjh.v14.i9.1757]
Corresponding Author of This Article
Jamak Modaresi Esfeh, MD, Staff Physician, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, United States. modarej@ccf.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Sep 27, 2022; 14(9): 1757-1766 Published online Sep 27, 2022. doi: 10.4254/wjh.v14.i9.1757
Positive autoantibodies in living liver donors
Joyce Loh, Koji Hashimoto, Choon Hyuck David Kwon, Masato Fujiki, Jamak Modaresi Esfeh
Joyce Loh, Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
Koji Hashimoto, Choon Hyuck David Kwon, Masato Fujiki, Digestive Diseases Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
Jamak Modaresi Esfeh, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
Author contributions: Loh J designed, performed the research and analysis of the data and wrote the paper; Hashimoto K, Kwon CD, and Masato F helped with critical revisions of the study; Modaresi Esfeh J supervised, helped design the study, made critical revisions to the manuscript and gave final approval.
Institutional review board statement: This study was reviewed and approved by the Cleveland Clinic Foundation Institutional Review Board.
Informed consent statement: This study qualified by a Waiver of Informed Consent as determined by our hospital’s IRB as it was a retrospective study that involved no more than minimal risk to the subjects, could be reasonably carried out without the waiver, and was not a threat to the rights or welfare of the subjects.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jamak Modaresi Esfeh, MD, Staff Physician, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, United States. modarej@ccf.org
Received: May 5, 2022 Peer-review started: May 5, 2022 First decision: June 8, 2022 Revised: June 17, 2022 Accepted: September 8, 2022 Article in press: September 8, 2022 Published online: September 27, 2022 Processing time: 140 Days and 22.3 Hours
ARTICLE HIGHLIGHTS
Research background
Positive pre-transplant autoantibodies in donors are common and of unclear significance. There is a lack of data on the significance of positive donor autoantibodies on post-transplant outcomes in living liver donor transplantations.
Research motivation
The donor pool for liver transplantations remains limited and living liver donors help bridge the gap. It is therefore important to know whether positive autoantibodies in living donors have an effect on post-transplant outcomes and whether they should pose a barrier to transplantation.
Research objectives
The objective of this study was to analyze the significance of positive autoantibodies in donors on post-transplant outcomes and complications in recipients including rates of mortality, mortality, biliary strictures, biliary leaks, infection, and rejection.
Research methods
This retrospective study included all patients above the age of 18 who underwent living liver donor transplantations at our center over a nine-year period (2012-20201). Demographic data and autoantibody titers were collected and analyzed to determine if they were associated with worse post-transplantation outcomes, including higher rates of mortality, biliary strictures, biliary leaks, infection, or rejection.
Research results
Positive autoantibodies commonly associated with liver disease in donors were not correlated to higher rates of post-transplantation complications.
Research conclusions
Our results expand upon existing literature suggesting that autoantibody positivity in asymptomatic donors is not correlated to worse transplant outcomes and should not preclude donation in living donor liver transplantations.
Research perspectives
Larger prospective studies with longer lengths of follow-up are needed to identify whether these results can be broadly applied to a wider population and whether other factors such as ethnicity or socioeconomic status may play a role in long-term transplantation outcomes.
