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Acute allograft rejection in liver transplant recipients: Incidence, risk factors, treatment success, and impact on graft failure.
Dogan, Nurettin; Hüsing-Kabar, Anna; Schmidt, Hartmut H; Cicinnati, Vito R; Beckebaum, Susanne; Kabar, Iyad.
Afiliación
  • Dogan N; Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany.
  • Hüsing-Kabar A; Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany.
  • Schmidt HH; Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany.
  • Cicinnati VR; Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany.
  • Beckebaum S; Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany.
  • Kabar I; Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany.
J Int Med Res ; 46(9): 3979-3990, 2018 Sep.
Article en En | MEDLINE | ID: mdl-29996675
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de los Conductos Biliares / Trasplante de Hígado / Aloinjertos / Rechazo de Injerto / Supervivencia de Injerto Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Int Med Res Año: 2018 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de los Conductos Biliares / Trasplante de Hígado / Aloinjertos / Rechazo de Injerto / Supervivencia de Injerto Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Int Med Res Año: 2018 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido