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World J Gastrointest Surg. May 27, 2026; 18(5): 117518
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.117518
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.117518
Impact of donor-specific antibodies on immune rejection rates in liver transplantation: A systematic review and meta-analysis
Lu-Yi Zhang, Yu-Hang Ling, Hong-Quan Zhang, Cheng-Wu Tang, Qin-Liang Mo, Department of General Surgery, Huzhou Key Laboratory of Translational Medicine, Huzhou First People’s Hospital, The First Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
Co-corresponding authors: Cheng-Wu Tang and Qin-Liang Mo.
Author contributions: Zhang LY performed data extraction, statistical analyses and data interpretation; Ling YH drafted the initial manuscript; Ling YH and Zhang HQ confirmed the authenticity of all the raw data; Zhang HQ, Tang CW, and Mo QL revised the manuscript for important intellectual content; Tang CW and Mo QL contributed to the conceptualization, design of the study, and they contributed equally to this work and are co-corresponding authors. All authors read and approved the final version of the manuscript.
Supported by Postgraduate Research and Innovation Project of Huzhou University, No. 2025KYCX104.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Cheng-Wu Tang, PhD, Department of General Surgery, Huzhou Key Laboratory of Translational Medicine, Huzhou First People’s Hospital, The First Affiliated Hospital of Huzhou University, No. 158 Guangchanghou Road, Wuxing District, Huzhou 313000, Zhejiang Province, China. dr_tcw@163.com
Received: January 16, 2026
Revised: February 12, 2026
Accepted: March 19, 2026
Published online: May 27, 2026
Processing time: 131 Days and 5.3 Hours
Revised: February 12, 2026
Accepted: March 19, 2026
Published online: May 27, 2026
Processing time: 131 Days and 5.3 Hours
Core Tip
Core Tip: This meta-analysis evaluates the impact of donor-specific antibodies (DSAs) on immune rejection following liver transplantation. While the presence of DSAs alone may not consistently predict rejection, quantitative measures - specifically high mean fluorescence intensity levels - are significantly correlated with increased rejection risk. These findings suggest that standardized, quantitative DSA monitoring, rather than simple qualitative detection, is essential for guiding personalized immunosuppressive protocols and optimizing long-term graft survival.