Incidence and risk factors of subclinical rejection after pediatric liver transplantation, and impact on allograft fibrosis

被引：0

作者：

Zhang, Zhixin ^{[1
]}

Zhao, Shengqiao ^{[1
]}

Si, Zhuyuan ^{[1
]}

Wang, Zhenglu ^{[2
]}

Dong, Chong ^{[2
]}

Sun, Chao ^{[2
]}

Zheng, Weiping ^{[2
]}

Kai, Wang ^{[2
]}

Zhang, Wei ^{[2
]}

Song, Zhuolun ^{[2
]}

Gao, Wei ^{[2
,3
]}

Shen, Zhongyang ^{[2
]}

机构：

[1] Tianjin Med Univ, Cent Clin Inst 1, Tianjin, Peoples R China

[2] Tianjin First Cent Hosp, Organ Transplantat Ctr, Dept Pediat Transplantat, Tianjin Key Lab Organ Transplantat, Tianjin, Peoples R China

[3] Tianjin First Cent Hosp, Organ Transplantat Ctr, Dept Pediat Transplantat, 24 Fukang Rd, Tianjin 300192, Peoples R China

来源：

CLINICAL TRANSPLANTATION | 2023年 / 37卷 / 02期

基金：

中国国家自然科学基金;

关键词：

allograft fibrosis; pediatric liver transplantation; risk factors; subclinical rejection; GRAFT FIBROSIS; LIVING DONOR; ANTIBODIES; RECIPIENTS;

D O I：

10.1111/ctr.14894

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

IntroductionSubclinical rejection (SCR) is a common injury in protocol biopsy after pediatric liver transplantation (pLT), but its effect on the recipient is not clearly understood. We herein investigated the incidence and risk factors involved in SCR and analyzed the relationship between SCR and allograft fibrosis (AF). MethodsWe retrospectively reviewed the biopsy results from 507 children between May 2013 and May 2019, and 352 patients underwent protocol biopsy 2 years after pLT, 203 underwent protocol biopsy 5 years after pLT, and 48 underwent protocol biopsy both 2 and 5 years after pLT. ResultsThe incidence of SCR in the 5-year group was higher than that in the 2-year group (20.2% vs.13.4%, respectively, p = .033). The number of patients with mild and moderate SCR in the 5-year group was also higher than that in the 2-year group (p = .039). Logistic regression analysis showed that acute rejection before liver biopsy and deceased donor liver transplantation (DDLT) were independent risk factors for SCR in the two groups, and that the incidence and severity of AF in protocol biopsies at both periods in the SCR group were higher than those in the non-SCR group (p < .05). ConclusionsThe incidence and severity of SCR increased with the prolongation of protocol biopsy time. We postulate that acute rejection and DDLT are independent risk factors for SCR after transplantation. As the occurrence of SCR also augmented the incidence and severity of AF.

引用

页数：10

共 32 条

[1] Meta-analysis and meta-regression of outcomes for adult living donor liver transplantation versus deceased donor liver transplantation [J].

Barbetta, Arianna ;

Aljehani, Mayada ;

Kim, Michelle ;

Tien, Christine ;

Ahearn, Aaron ;

Schilperoort, Hannah ;

Sher, Linda ;

Emamaullee, Juliet .

AMERICAN JOURNAL OF TRANSPLANTATION, 2021, 21 (07) :2399-2412

[2] Cytokine concentrations and regulatory T cells in living donor and deceased donor liver transplant recipients [J].

Briem-Richter, Andrea ;

Leuschner, Alexander ;

Haag, Friedrich ;

Grabhorn, Enke ;

Ganschow, Rainer .

PEDIATRIC TRANSPLANTATION, 2013, 17 (02) :185-190

[3] 2016 Comprehensive Update of the Banff Working Group on Liver Allograft Pathology: Introduction of Antibody-Mediated Rejectio [J].

Demetris, A. J. ;

Bellamy, C. ;

Hubscher, S. G. ;

O'Leary, J. ;

Randhawa, P. S. ;

Feng, S. ;

Neil, D. ;

Colvin, R. B. ;

McCaughan, G. ;

Fung, J. J. ;

Del Bello, A. ;

Reinholt, F. P. ;

Haga, H. ;

Adeyi, O. ;

Czaja, A. J. ;

Schiano, T. ;

Fiel, M. I. ;

Smith, M. L. ;

Sebagh, M. ;

Tanigawa, R. Y. ;

Yilmaz, F. ;

Alexander, G. ;

Baiocchi, L. ;

Balasubramanian, M. ;

Batal, I. ;

Bhan, A. K. ;

Bucuvalas, J. ;

Cerski, C. T. S. ;

Charlotte, F. ;

de Vera, M. E. ;

ElMonayeri, M. ;

Fontes, P. ;

Furth, E. E. ;

Gouw, A. S. H. ;

Hafezi-Bakhtiari, S. ;

Hart, J. ;

Honsova, E. ;

Ismail, W. ;

Itoh, T. ;

Jhala, N. C. ;

Khettry, U. ;

Klintmalm, G. B. ;

Knechtle, S. ;

Koshiba, T. ;

Kozlowski, T. ;

Lassman, C. R. ;

Lerut, J. ;

Levitsky, J. ;

Licini, L. ;

Liotta, R. .

AMERICAN JOURNAL OF TRANSPLANTATION, 2016, 16 (10) :2816-2835

[4] Pediatric liver transplantation: where do we stand? Where we are going to? [J].

Devictor, Denis ;

Tissieres, Pierre .

EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY, 2013, 7 (07) :629-641

[5] Efficacy and Safety of Immunosuppression Withdrawal in Pediatric Liver Transplant Recipients: Moving Toward Personalized Management [J].

Feng, Sandy ;

Bucuvalas, John C. ;

Mazariegos, George, V ;

Magee, John C. ;

Sanchez-Fueyo, Alberto ;

Spain, Katharine M. ;

Lesniak, Andrew ;

Kanaparthi, Sai ;

Perito, Emily ;

Venkat, Veena L. ;

Burrell, Bryna E. ;

Alonso, Estella M. ;

Bridges, Nancy D. ;

Doo, Edward ;

Gupta, Nitika A. ;

Himes, Ryan W. ;

Ikle, David ;

Jackson, Annette M. ;

Lobritto, Steven J. ;

Lozano, Juan Jose ;

Martinez, Mercedes ;

Ng, Vicky L. ;

Rand, Elizabeth B. ;

Sherker, Averell H. ;

Sundaram, Shikha S. ;

Turmelle, Yumirle P. ;

Wood-Trageser, Michele ;

Demetris, Anthony J. .

HEPATOLOGY, 2021, 73 (05) :1985-2004

[6] Evidence of Chronic Allograft Injury in Liver Biopsies From Long-term Pediatric Recipients of Liver Transplants [J].

Feng, Sandy ;

Bucuvalas, John C. ;

Demetris, Anthony J. ;

Burrell, Bryna E. ;

Spain, Katherine M. ;

Kanaparthi, Sai ;

Magee, John C. ;

Ikle, David ;

Lesniak, Andrew ;

Lozano, Juan J. ;

Alonso, Estella M. ;

Bray, Robert A. ;

Bridges, Nancy E. ;

Doo, Edward ;

Gebel, Howard M. ;

Gupta, Nitika A. ;

Himes, Ryan W. ;

Jackson, Annette M. ;

Lobritto, Steven J. ;

Mazariegos, George V. ;

Ng, Vicky L. ;

Rand, Elizabeth B. ;

Sherker, Averell H. ;

Sundaram, Shikha ;

Turmelle, Yumirle P. ;

Sanchez-Fueyo, Alberto .

GASTROENTEROLOGY, 2018, 155 (06) :1838-+

[7] Tolerance after liver transplantation: Where are we? [J].

Feng, Sandy ;

Bucuvalas, John .

LIVER TRANSPLANTATION, 2017, 23 (12) :1601-1614

[8] Five-Year Histological and Serological Follow-up of Operationally Tolerant Pediatric Liver Transplant Recipients Enrolled in WISP-R [J].

Feng, Sandy ;

Demetris, Anthony J. ;

Spain, Katharine M. ;

Kanaparthi, Sai ;

Burrell, Bryna E. ;

Ekong, Udeme D. ;

Alonso, Estella M. ;

Rosenthal, Philip ;

Turka, Laurence A. ;

Ikle, David ;

Tchao, Nadia K. .

HEPATOLOGY, 2017, 65 (02) :647-660

[9] Non-invasive screening for subclinical liver graft injury in adults via donor-specific anti-HLA antibodies [J].

Hoefer, Anne ;

Jonigk, Danny ;

Hartleben, Bjoern ;

Verboom, Murielle ;

Hallensleben, Michael ;

Manns, Michael P. ;

Jaeckel, Elmar ;

Taubert, Richard .

SCIENTIFIC REPORTS, 2020, 10 (01)

[10] DSA Are Associated With More Graft Injury, More Fibrosis, and Upregulation of Rejection-associated Transcripts in Subclinical Rejection [J].

Hoefer, Anne ;

Jonigk, Danny ;

Hartleben, Bjoern ;

Verboom, Murielle ;

Hallensleben, Michael ;

Huebscher, Stefan G. ;

Manns, Michael P. ;

Jaeckel, Elmar ;

Taubert, Richard .

TRANSPLANTATION, 2020, 104 (03) :551-561

← 1 2 3 4 →