Risk factors for acute liver allograft rejection and their influences on treatment outcomes of rescue therapy in living donor liver transplantation.
Clin Transplant
; 30(8): 880-5, 2016 08.
Article
en En
| MEDLINE
| ID: mdl-27146588
ABSTRACT
BACKGROUND:
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.METHODS:
A prospective database of 413 consecutive adult patients who underwent living donor liver transplantation (LDLT) was reviewed.RESULTS:
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.CONCLUSIONS:
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Terapia de Inmunosupresión
/
Trasplante de Hígado
/
Rechazo de Injerto
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Clin Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2016
Tipo del documento:
Article
País de afiliación:
Japón