Do graft type or donor source affect acute rejection rates after liver transplant: a multivariate analysis.

ABSTRACT

We looked at acute rejection (AR) rates in adult liver transplant recipients to determine if graft type (whole liver vs. partial liver) or donor source (living vs. deceased donor) influenced the risk for AR. Between 1999 and 2005, we performed 292 whole liver transplants from a deceased donor (DD-WL) and 91 partial transplants, either from a living donor (LDLT, n = 59) or split liver from a deceased donor (DD-SL, n = 32). Pediatric recipients were not included. The groups were well matched by age and type of liver disease (p = ns), but mean model for end-stage liver disease (MELD) scores were higher in the DD-WL vs. LD recipient groups (p < 0.01). Immunosuppression was similar for all. AR rates at 12 months post-transplant were lower in the LDLT group (10.0%) vs. the DD-WL group (16.5%, p = 0.10), although this was not statistically significant. AR rates in the DD-SL transplant group (12.8%) were intermediate compared with the two other groups and not statistically different from either group (p = ns). By multivariate analysis, however, neither graft type (partial vs. whole) nor donor source (LD vs. DD) seemed to have an impact on the risk for AR. The only factor that was associated with an increased risk for AR was not using induction therapy.