Journal article
Risk factors for acute liver allograft rejection and their influences on treatment outcomes of rescue therapy in living donor liver transplantation
Clinical transplantation, Vol.30(8), pp.880-885
08/2016
DOI: 10.1111/ctr.12760
PMID: 27146588
Abstract
Several clinical factors are reportedly correlated with acute cellular rejection (ACR) after liver transplantation. However, the factors that determine the response to rescue therapies remain unclear.
A prospective database of 413 consecutive adult patients who underwent living donor liver transplantation (LDLT) was reviewed.
Ninety-nine (24%) patients developed ACR after LDLT. A multivariate analysis revealed that a positive T-lymphocytotoxic test (odds ratio [OR], 3.85; P=.017), HLA-DR mismatch (OR, 2.99; P=.013), autoimmune disease (OR, 2.61; P=.001), and a younger recipient age (OR, 0.60 for +10 years; P<.001) were independent risk factors for ACR. Among these, autoimmune disease was significantly correlated with refractoriness to the standard rescue therapy (53% vs 30%, P=.02) and relapse of cellular rejection (34% vs 16%, P=.04). After rescue therapy, 98 of the 99 (99%) patients eventually recovered from ACR and graft loss was observed in only one patient. None of the risk factors for ACR impaired both graft survival and overall survival after LDLT.
Autoimmune liver disease is associated with refractoriness to rescue therapy for ACR and the relapse of rejection. However, ACR does not affect the long-term outcomes of LDLT if it is well controlled.
Details
- Title: Subtitle
- Risk factors for acute liver allograft rejection and their influences on treatment outcomes of rescue therapy in living donor liver transplantation
- Creators
- Junichi Shindoh - Hepatobiliary-Pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital, Tokyo, JapanNobuhisa Akamatsu - Artificial Organs and Transplantation Division, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanTomohiro Tanaka - Organ Transplantation Service, The University of Tokyo Hospital, Tokyo, JapanJunichi Kaneko - Artificial Organs and Transplantation Division, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanSumihito Tamura - Artificial Organs and Transplantation Division, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanYoshihiro Sakamoto - Artificial Organs and Transplantation Division, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanKiyoshi Hasegawa - Artificial Organs and Transplantation Division, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanYasuhiko Sugawara - Department of Hepatobiliary-Pancreatic Surgery, Japan Red Cross Medical Center, Tokyo, JapanMasatoshi Makuuchi - Department of Hepatobiliary-Pancreatic Surgery, Japan Red Cross Medical Center, Tokyo, JapanNorihiro Kokudo - Artificial Organs and Transplantation Division, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Resource Type
- Journal article
- Publication Details
- Clinical transplantation, Vol.30(8), pp.880-885
- DOI
- 10.1111/ctr.12760
- PMID
- 27146588
- ISSN
- 0902-0063
- eISSN
- 1399-0012
- Language
- English
- Date published
- 08/2016
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984094533602771
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