Acute allograft rejection in liver transplant recipients: Incidence, risk factors, treatment success, and impact on graft failure. Issue 9 (September 2018)

• Record Type: Journal Article
• Authors: Dogan, Nurettin; Hüsing-Kabar, Anna; Schmidt, Hartmut H.; Cicinnati, Vito R.; Beckebaum, Susanne; Kabar, Iyad
• Is Part Of: Journal of international medical research. Volume 46:Issue 9(2018)
• Page Start: 3979
• Page End: 3990
• Publication Date: 2018-09
• Subjects: Liver transplantation -- acute cellular rejection -- biliary complications -- sex mismatch -- cytomegalovirus mismatch -- corticosteroids; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060518785543
• Languages: English
• ISSNs: 0300-0605

Abstract

Objective: This study was performed to identify risk factors for acute cellular rejection after liver transplantation (LT). Methods: Consecutive LT recipients who underwent surgery in our institution from 2002 to 2015 were retrospectively evaluated. Results: In total, 176 patients were eligible for statistical analysis. During a mean observation period of 61.1 ± 36.3 months, 43 episodes of acute rejection were evident. Of these, 34 (79.0%) were responsive to methylprednisolone, 3 (7.0%) were treated by adjusting the dosage of immunosuppressive agents, and 6 (14.0%) were methylprednisolone-resistant and treated using anti-thymocyte globulin. Biliary complications (odds ratio [OR] = 4.89, 95% confidence interval [CI] = 2.00–11.98); donor-negative, recipient-positive CMV mismatch ( OR = 9.88, 95% CI = 1.18–82.36); sex mismatch (OR = 3.16, 95% CI = 1.31–8.10); and sex mismatch with a female donor (OR = 3.00, 95% CI = 1.10–7.58) were identified as significant risk factors for acute graft rejection after LT. Conclusion: In patients who develop acute cellular rejection after LT, biliary complications should be evaluated as a potential cause. Most acute rejections after LT respond to bolus corticosteroid therapy.