Incidence of Late Acute Rejection in Living Donor Liver Transplant Patients, Risk Factors, and the Role of Immunosuppressive Drugs

Transplant Proc. 2015 Jun;47(5):1474-7. doi: 10.1016/j.transproceed.2015.04.076.

Abstract

Introduction: Late acute rejection (LAR) is a clinical manifestation that occurs 6 months after liver transplantation, shows histopathologic features different from those of acute rejection, and is the cause of a high prevalence of morbidity and mortality.

Methods: In this study, hospital records of 211 living donor liver transplantation (LDLT) patients who underwent surgery in our clinic between June 2000 and February 2014 were reviewed retrospectively. The patients were ≥ 18 years old and were followed for ≥ 6 months.

Results: Of the 211 patients, 21 (9.9%; 16 males, 5 females) developed LAR. The mean age of the patients was 46 years (range, 33-58). The mean follow-up period was 61.2 months (range, 6-152) and the median time to development of LAR was 26.4 months (range, 7-77). In our study, patients who received cyclosporine and mycophenolate mofetil (MMF) treatment developed more LAR than did patients who received tacrolimus and MMF therapy (P = .05). In addition, the incidence of LAR in patients who underwent LDLT was significantly greater in the ABO-matched groups than in the ABO identical group (P = .028).

Conclusions: Development of LAR and serious complications related to it can be avoided if liver transplant recipients are followed regularly and closely in outpatient clinics after transplantation.

MeSH terms

  • Adult
  • Female
  • Graft Rejection / drug therapy
  • Graft Rejection / epidemiology*
  • Graft Rejection / immunology
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Incidence
  • Liver Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Turkey / epidemiology

Substances

  • Immunosuppressive Agents