Department of Surgery, Multivisceral Transplant Centre, Hopital Hautepierre, University of Strasbourg, Strasbourg, France.
J Gastroenterol Hepatol. 2011 Dec;26(12):1772-8. doi: 10.1111/j.1440-1746.2011.06772.x.
The objective of this 11-year cohort retrospective study conducted in adult patients with chronic hepatitis C virus (HCV) who underwent liver transplantation (LT) was to identify whether human leukocyte antigen (HLA) mismatching is associated with the recurrence of HCV and with the time to recurrence of HCV.
Among the 181 patients (74% men; mean age: 54 years, range 25-71) who underwent a LT between 1995 and 2006 in the study center, 163 had relevant data in their medical chart documenting HCV recurrence, and 107 (65.64%) reported a histological evidence of HCV recurrence.
Survival was 78% at 5 years. There was no significant relationship between the total score of HLA-mismatches and the recurrence of HCV. Similarly, there was no significant relationship between the total score of HLA mismatches and the time to recurrence of HCV. For the analyses at each individual locus, a significant relationship between the individual scores of HLA-mismatches and the recurrence of HCV were observed. Out of the 40 patients who experienced a rejection, the rate of recurrence was not different according to the severity of the rejection (75% mild, 64% moderate and 64% for severe rejection).
In conclusion, this large study did not demonstrate any relationship between the total score of HLA mismatches and HCV-recurrence. Contrarily a significant relationship between the individual scores of HLA mismatches (HLA-A3, HLA-B35, HLA-DR3, HLA-DR7, HLA-DQ2, HLA-DQ2-0) and the recurrence of HCV were observed.
本研究为一项回顾性队列研究，共纳入 181 例慢性丙型肝炎病毒（HCV）成人肝移植患者，随访时间为 11 年。研究目的在于明确人类白细胞抗原（HLA）错配是否与 HCV 复发及 HCV 复发时间相关。
研究中心于 1995 年至 2006 年期间共进行了 181 例肝移植手术，其中 163 例患者的病历资料中记录了 HCV 复发的相关信息，107 例（65.64%）患者存在 HCV 复发的组织学证据。
患者 5 年总体生存率为 78%。HLA 错配总评分与 HCV 复发之间无显著相关性。同样，HLA 错配总评分与 HCV 复发时间之间也无显著相关性。在对各个 HLA 位点的评分进行分析时，发现 HLA 错配的个体评分与 HCV 复发之间存在显著相关性。在 40 例发生排斥反应的患者中，根据排斥反应的严重程度，复发率无显著差异（轻度 75%，中度 64%，重度 64%）。
综上所述，本研究并未发现 HLA 错配总评分与 HCV 复发之间存在相关性。相反，发现 HLA 错配的个体评分（HLA-A3、HLA-B35、HLA-DR3、HLA-DR7、HLA-DQ2、HLA-DQ2-0）与 HCV 复发之间存在显著相关性。
