Liver transplantationOutcomeThe Incidence and Management of Acute and Chronic Rejection After Living Donor Liver Transplantation
Section snippets
Materials and methods
The 132 primary liver allograft recipients underwent LDLT between January 1999 and May 2004. We excluded patients who died in early posttransplant period (during the first months). All patients were followed until April 2005. They were evaluated monthly over the first 12 months, and every 3 months thereafter. The standard evaluation included a physical examination, liver function tests, and serological viral tests when necessary. Liver biopsies were performed when clinically indicated.
Liver
Donor and Recipient Characteristics
The study group consisted of 90 male and 42 female recipients of mean recipient age at the time of transplantation 36 years (range = 0.5 to 63; median 41.50). There were 25 pediatric and 107 adult cases. The causes of end-stage liver disease are shown in Table 1.
The donor was blood related in all but 13 cases. There were 81 female and 51 male donors with a mean age of 35 years (range: 19 to 64). There was no ABO-incompatible graft. The source of the graft was the right lobe in 103 patients;
Discussion
In this study we sought to document the incidence, severity, and outcome of acute and chronic rejection by evaluation of histological and clinical data. In this series of 132 LDLT recipients, clinical and biopsy-proven AREs were detected in 24% and 11% of patients, respectively. Sixteen percent of the pediatric and 11% of the adult recipients developed at least one ARE.
Among the pediatric LDLT series the overall incidence of ARE has been reported to be between 61% and 74%, whereas the rate was
References (13)
- et al.
Allograft rejection in pediatric recipients of living related liver transplants
Hepatology
(1996) - et al.
Pediatric liver transplantation with cadaveric or living related donorscomparative results in 90 elective recipients of primary grafts
J Pediatr
(1999) - et al.
Single-center analysis of the first adult-to-adult living donor liver transplants using the right lobe
Liver Transpl
(2000) - et al.
Tacrolimus dosing requirements and concentrations in adult living donor liver transplant recipients
Liver Transpl
(2002) - et al.
Cadaveric full-size liver transplantation and the graft alternatives in adultsa comparative study from a single centre
J Hepatol
(2006) Is it right to develop living related liver transplantation? Do reduced and split livers not suffice to cover the needs?
Transpl Int
(1995)
Cited by (15)
Pediatric living donor liver transplantation (LDLT): Short- and long-term outcomes during sixteen years period at a single centre- A retrospective cohort study
2022, Annals of Medicine and SurgeryCitation Excerpt :It was correlated with patient loss in our series; also, it was a major cause of death in Kitajima et al., 2018 [34] study. However, it did not affect graft or patient survival in Yilmaz et al., 2006 [40] or Shehata et al., 2012 [58] studies. Despite advanced immunosuppression after LT; chronic rejection remains a major reason for graft and/or patient loss [42,43,59,64].
Acute Liver Allograft Rejection After Living Donor Liver Transplantation: Risk Factors and Patient Survival
2018, American Journal of the Medical SciencesCitation Excerpt :In this period, patients have the strongest immune response, which induces the highest incidence of AR. In other adult LDLT series, more than 90% of AR was observed within the first year after LDLT.17,18 Our results showed more AR occurred in the early period after transplantation.
Acute and Chronic Rejection After Liver Transplantation: What A Clinician Needs to Know
2017, Journal of Clinical and Experimental HepatologyCitation Excerpt :A meta-analysis comparing Cyclosporine and Tacrolimus showed that Tacrolimus based therapy was associated with less CR and better long-term outcomes.60 The later studies with Tacrolimus based immunosuppression showed a 2–9% incidence of CR in liver transplantation as shown in Table 4.7,8,28,34,61–63 In the largest series published in the Tacrolimus era, CR was present in only 3.1% (32/1048).7
Acute rejection on immune-mediated chronic rejection after liver transplantation
2021, Gazzetta Medica Italiana Archivio per le Scienze MedichePediatric Living Donor Liver Transplant in Indonesia's National Referral Hospital
2020, Transplantation