Incidence and severity of acute cellular rejection in recipients undergoing adult living donor or deceased donor liver transplantation

A. Shaked, R. M. Ghobrial, R. M. Merion, T. H. Shearon, J. C. Emond, Jeffrey Fair, R. A. Fisher, L. M. Kulik, T. L. Pruett, N. A. Terrault

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Living donor liver transplantation (LDLT) may have better immunological outcomes compared to deceased donor liver transplantation (DDLT). The aim of this study was to analyze the incidence of acute cellular rejection (ACR) after LDLT and DDLT. Data from the adult-to-adult living donor liver transplantation (A2ALL) retrospective cohort study on 593 liver transplants done between May 1998 and March 2004 were studied (380 LDLT; 213 DDLT). Median LDLT and DDLT follow-up was 778 and 713 days, respectively. Rates of clinically treated and biopsy-proven ACR were compared. There were 174 (46%) LDLT and 80 (38%) DDLT recipients with ≥1 clinically treated episodes of ACR, whereas 103 (27%) LDLT and 58 (27%) DDLT recipients had ≥1 biopsy-proven ACR episode. A higher proportion of LDLT recipients had clinically treated ACR (p = 0.052), but this difference was largely attributable to one center. There were similar proportions of biopsy-proven rejection (p = 0.97) and graft loss due to rejection (p = 0.16). Longer cold ischemia time was associated with a higher rate of ACR in both groups despite much shorter median cold ischemia time in LDLT. These data do not show an immunological advantage for LDLT, and therefore do not support the application of unique posttransplant immunosuppression protocols for LDLT recipients.

Original languageEnglish (US)
Pages (from-to)301-308
Number of pages8
JournalAmerican Journal of Transplantation
Volume9
Issue number2
DOIs
StatePublished - Feb 2009
Externally publishedYes

Fingerprint

Living Donors
Liver Transplantation
Tissue Donors
Incidence
Cold Ischemia
Biopsy
Transplants

Keywords

  • Acute rejection
  • Cold ischemia injury
  • LDLT
  • Liver regeneration

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Incidence and severity of acute cellular rejection in recipients undergoing adult living donor or deceased donor liver transplantation. / Shaked, A.; Ghobrial, R. M.; Merion, R. M.; Shearon, T. H.; Emond, J. C.; Fair, Jeffrey; Fisher, R. A.; Kulik, L. M.; Pruett, T. L.; Terrault, N. A.

In: American Journal of Transplantation, Vol. 9, No. 2, 02.2009, p. 301-308.

Research output: Contribution to journalArticle

Shaked, A. ; Ghobrial, R. M. ; Merion, R. M. ; Shearon, T. H. ; Emond, J. C. ; Fair, Jeffrey ; Fisher, R. A. ; Kulik, L. M. ; Pruett, T. L. ; Terrault, N. A. / Incidence and severity of acute cellular rejection in recipients undergoing adult living donor or deceased donor liver transplantation. In: American Journal of Transplantation. 2009 ; Vol. 9, No. 2. pp. 301-308.
@article{a794e584ce4445ef8cfbf878538b10de,
title = "Incidence and severity of acute cellular rejection in recipients undergoing adult living donor or deceased donor liver transplantation",
abstract = "Living donor liver transplantation (LDLT) may have better immunological outcomes compared to deceased donor liver transplantation (DDLT). The aim of this study was to analyze the incidence of acute cellular rejection (ACR) after LDLT and DDLT. Data from the adult-to-adult living donor liver transplantation (A2ALL) retrospective cohort study on 593 liver transplants done between May 1998 and March 2004 were studied (380 LDLT; 213 DDLT). Median LDLT and DDLT follow-up was 778 and 713 days, respectively. Rates of clinically treated and biopsy-proven ACR were compared. There were 174 (46{\%}) LDLT and 80 (38{\%}) DDLT recipients with ≥1 clinically treated episodes of ACR, whereas 103 (27{\%}) LDLT and 58 (27{\%}) DDLT recipients had ≥1 biopsy-proven ACR episode. A higher proportion of LDLT recipients had clinically treated ACR (p = 0.052), but this difference was largely attributable to one center. There were similar proportions of biopsy-proven rejection (p = 0.97) and graft loss due to rejection (p = 0.16). Longer cold ischemia time was associated with a higher rate of ACR in both groups despite much shorter median cold ischemia time in LDLT. These data do not show an immunological advantage for LDLT, and therefore do not support the application of unique posttransplant immunosuppression protocols for LDLT recipients.",
keywords = "Acute rejection, Cold ischemia injury, LDLT, Liver regeneration",
author = "A. Shaked and Ghobrial, {R. M.} and Merion, {R. M.} and Shearon, {T. H.} and Emond, {J. C.} and Jeffrey Fair and Fisher, {R. A.} and Kulik, {L. M.} and Pruett, {T. L.} and Terrault, {N. A.}",
year = "2009",
month = "2",
doi = "10.1111/j.1600-6143.2008.02487.x",
language = "English (US)",
volume = "9",
pages = "301--308",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Incidence and severity of acute cellular rejection in recipients undergoing adult living donor or deceased donor liver transplantation

AU - Shaked, A.

AU - Ghobrial, R. M.

AU - Merion, R. M.

AU - Shearon, T. H.

AU - Emond, J. C.

AU - Fair, Jeffrey

AU - Fisher, R. A.

AU - Kulik, L. M.

AU - Pruett, T. L.

AU - Terrault, N. A.

PY - 2009/2

Y1 - 2009/2

N2 - Living donor liver transplantation (LDLT) may have better immunological outcomes compared to deceased donor liver transplantation (DDLT). The aim of this study was to analyze the incidence of acute cellular rejection (ACR) after LDLT and DDLT. Data from the adult-to-adult living donor liver transplantation (A2ALL) retrospective cohort study on 593 liver transplants done between May 1998 and March 2004 were studied (380 LDLT; 213 DDLT). Median LDLT and DDLT follow-up was 778 and 713 days, respectively. Rates of clinically treated and biopsy-proven ACR were compared. There were 174 (46%) LDLT and 80 (38%) DDLT recipients with ≥1 clinically treated episodes of ACR, whereas 103 (27%) LDLT and 58 (27%) DDLT recipients had ≥1 biopsy-proven ACR episode. A higher proportion of LDLT recipients had clinically treated ACR (p = 0.052), but this difference was largely attributable to one center. There were similar proportions of biopsy-proven rejection (p = 0.97) and graft loss due to rejection (p = 0.16). Longer cold ischemia time was associated with a higher rate of ACR in both groups despite much shorter median cold ischemia time in LDLT. These data do not show an immunological advantage for LDLT, and therefore do not support the application of unique posttransplant immunosuppression protocols for LDLT recipients.

AB - Living donor liver transplantation (LDLT) may have better immunological outcomes compared to deceased donor liver transplantation (DDLT). The aim of this study was to analyze the incidence of acute cellular rejection (ACR) after LDLT and DDLT. Data from the adult-to-adult living donor liver transplantation (A2ALL) retrospective cohort study on 593 liver transplants done between May 1998 and March 2004 were studied (380 LDLT; 213 DDLT). Median LDLT and DDLT follow-up was 778 and 713 days, respectively. Rates of clinically treated and biopsy-proven ACR were compared. There were 174 (46%) LDLT and 80 (38%) DDLT recipients with ≥1 clinically treated episodes of ACR, whereas 103 (27%) LDLT and 58 (27%) DDLT recipients had ≥1 biopsy-proven ACR episode. A higher proportion of LDLT recipients had clinically treated ACR (p = 0.052), but this difference was largely attributable to one center. There were similar proportions of biopsy-proven rejection (p = 0.97) and graft loss due to rejection (p = 0.16). Longer cold ischemia time was associated with a higher rate of ACR in both groups despite much shorter median cold ischemia time in LDLT. These data do not show an immunological advantage for LDLT, and therefore do not support the application of unique posttransplant immunosuppression protocols for LDLT recipients.

KW - Acute rejection

KW - Cold ischemia injury

KW - LDLT

KW - Liver regeneration

UR - http://www.scopus.com/inward/record.url?scp=58849085921&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58849085921&partnerID=8YFLogxK

U2 - 10.1111/j.1600-6143.2008.02487.x

DO - 10.1111/j.1600-6143.2008.02487.x

M3 - Article

C2 - 19120082

AN - SCOPUS:58849085921

VL - 9

SP - 301

EP - 308

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 2

ER -