Risk factors for acute rejection in liver transplantation and its impact on the outcomes of recipients |
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| Affiliation: | 1. Medical School of Ningbo University, Ningbo, Zhejiang, China;2. Department of Hepato-Pancreato-Biliary Surgery, Ningbo Medical Center Lihuili Hospital, The affiliated hospital of Ningbo University, Ningbo, Zhejiang, China;1. Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China;2. Department of Anesthesiology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300100, China;3. Department of Anesthesiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China;4. Department of General Surgery, Tianjin Public Security Hospital, Tianjin 300042, China;1. Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, National Quality Control Center for Donated Organ Procurement, Hubei Key Laboratory of Medical Technology on Transplantation, Hubei Clinical Research Center for Natural Polymer Biological Liver, Hubei Engineering Center of Natural Polymer-based Medical Materials, Wuhan, Hubei Province 43007, PR China;2. The 3rd Xiangya Hospital of Central South University, Research Center of National Health Ministry on Transplantation Medicine Engineering and Technology, Changsha, Hunan, Province 410013, PR China;1. Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China;2. Department of Gastroenterology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315000, Zhejiang Province, China;3. Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, Zhejiang Province, China;4. Department of Pharmacy, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315000, Zhejiang Province, China.;1. Key Laboratory of Cell Engineering of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China;2. The Clinical Stem Cell Research Institute, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China;3. Department of Dermatology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China;1. Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, Shandong, PR China;2. The Fourth Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, PR China;3. Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing, PR China;4. Department of Neurology, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong, PR China;5. Institute of Liver Diseases, Affiliated Hospital of Jining Medical University, Shandong, PR China;6. Shanghai Meifeng Biotechnology Co., Ltd, Shanghai, PR China;1. Klinik am See, Rehabilitationszentrum, Rüdersdorf, Germany;2. Medical University Brandenburg "Theodor Fontane", Germany;3. Universität Potsdam, Professur für Rehabilitationswissenschaften, humanwissenschaftliche Fakultät, Germany;4. Clinic of Dermatology, Immunology and Allergology, Medical Center Dessau, Medical University Brandenburg "Theodor Fontane" Medical Center Dessau, Germany |
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| Abstract: | ObjectiveTo determine the risk factors for acute rejection in liver transplantation and its impact on the outcomes of the recipients.MethodsClinicopathological data of 290 patients who underwent liver transplantation from January 2012 to December 2021 at our center were retrospectively evaluated. Patients were grouped into an acute rejection (AR) group and a normal (NM) group based on the confirmed histopathological diagnosis of acute rejection. Univariate and multivariate logistic regression were used to determine the risk factors for acute rejection.Results244 patients were included in the study. Acute rejection occurred in 27 (11.1%) of the patients. Warm ischemia time (P = 0.137), cold ischemia time (P = 0.064) and chronic liver failure (P = 0.001) were potential risk factors for acute rejection. Chronic liver failure (P < 0.001, OR = 8.22, 95% CI = 2.47–27.32) was the independent risk factor. There was no significant difference in overall survival between recipients with acute rejection and those without it (P = 0.985). The 1-, 3- and 5-year overall survival in the NM group was 98.1%, 85.7% and 78.6% respectively vs 88.9%, 82.5% and 82.5% respectively in the AR group.ConclusionAcute rejection does not appear to affect the long-term survival of the recipients. Only chronic liver failure was an independent risk factor for acute rejection. Our findings further illustrate that contradictions still exist on which factors influence acute rejection in liver transplant recipients.SummaryClinicopathological data of 290 liver transplant recipients at our center between January 2012 and December 2021 were retrospectively evaluated to determine the risk factors for acute rejection and its impact on the outcomes of the recipients. 244 patients were included in the analysis. 27 of the 244 experienced acute rejection. Propensity score matching was performed to reduce the confounding effect. Patients were assigned to an acute rejection group (n = 27) and a normal group (n = 54). Chronic liver failure (P < 0.001, OR = 8.22, 95% CI = 2.47–27.32) was the determined to be independent risk factor for acute rejection. Acute rejection did not appear to affect the long-term survival of the recipients and there was no significant difference in overall survival between the patients with acute rejection and those without it. |
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