UCLA LIVER-TRANSPLANTATION - ANALYSIS OF IMMUNOLOGICAL FACTORS AFFECTING OUTCOME

From 1988 to 1993, UCLA completed 938 first and 1,146 total orthotopic liver transplants (OLT). Race analysis demonstrated a 1-year patient survival of 89% in Blacks (n = 45) versus 80% in Whites (n = 492, p < 0.02), with no significant difference shown between Hispanics (n = 278 ) and Whites. The 1-year patient survival in Asians was 50% (n = 58, p < 0.02 vs. Whites) even when hepatitis B was excluded (59%, n = 43). The 1-year patient survival of hepatitis B surface antigen positive As ians (n = 15) was only 21% (p < 0.02 vs. all others). OLT patients who se panel reactive antibody (PRA) was < 10% (n = 339) demonstrated no g raft or patient survival advantage versus recipients whose PRA was >10 % (n = 71). A positive antidonor flow cytometry crossmatch (>30 mean c hannel shifts, n = 76) was associated with a decreased 1-year graft su rvival (56% vs. 73%, p < 0.05) when compared to flow negative recipien ts (n = 185). Graft survival for 0 DR mismatches was 74% at 1 year com pared with 57% for 1 DR mismatche (p ( 0.02) and 59% for 2 DR mismatch es (p < 0.02).