Late Acute Rejection in Liver Transplant: A Systematic Review

Nacif, Lucas Souto; Pinheiro, Rafael Soares; Pecora, Rafael A.; Ducatti, Liliana; Rocha-Santos, Vinícius; Andraus, Wellington; D’Albuquerque, Luiz Augusto Carneiro

doi:10.1590/s0102-67202015000300017

Cited by 32 publications

(37 citation statements)

References 11 publications

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“…As previously observed, in LT, late L‐TCMR was often associated with lower immunosuppression levels, including non‐adherence 7,8 . L‐TCMR was more refractory to immunosuppressive therapy, and the evolution of L‐TCMR might result in chronic rejection or zone 3 fibrosis 9‐11 . Furthermore, recent investigations have demonstrated that L‐TCMR was associated with increased long‐term risk of graft loss and decreased graft survival in adult LT 8 .…”

Section: Introductionmentioning

confidence: 71%

“…Late TCMR was defined as TCMR characterized by central veins or perivenular inflammation and an onset later than 3 months after LT in accordance with the Banff criteria and past literature (Figure 1). 8,10,15 Although either 3 months or 6 months can be used to define L‐TCMR due to the lack of a clear criterion for time‐to‐onset of L‐TCMR, 9 we adopted 3 months because steroid administration is stopped 3 months after the LT in accordance with our immunosuppression protocol described below. The L‐TCMR grades ranged from minimal or indeterminate to severe in accordance with the previously proposed criteria 10 .…”

Section: Methodsmentioning

confidence: 99%

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Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation

Takeda

Sakamoto

Irie

et al. 2020

Pediatric Transplantation

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Although poor long-term graft survival in LT in AYA is recognized, detailed epidemiological data are still lacking. L-TCMR may have poor outcomes. This study aimed to provide a detailed, epidemiological assessment of the association between AYA age and rejection. L-TCMR was defined in this study as TCMR with central vein or perivenular inflammation occurring later than 3 months after LT. A total of 342 patients who survived for at least 3 months after LT between 2005 and 2015 were enrolled.The AYA group (10-24 years) was compared with the C group (less than 10 years), and the incidence and outcomes of L-TCMR were analyzed. In total, 342 patients had LT; 38 of these were AYA with the mean follow-up period of 6.7 years. A total of 304 patients in C group had a mean follow-up period of 6.3 years (P = .28). The incidence of L-TCMR in AYA group was significantly higher than in C group (15.8% vs 4.6%, P = .006). The time to L-TCMR after LT was significantly shorter in AYA group (P = .01). Neither patient survival nor the incidence of non-adherence differed significantly between the groups (P = .18 and P = .89). The number of additional immunosuppressants after L-TCMR was significantly higher in the AYA group (P = .04). A high incidence of L-TCMR was observed in AYA group irrespective of non-adherence. AYA patients with L-TCMR should be followed carefully due to the poor results of posttreatment biopsy and the need for intensive immunosuppressive therapy. K E Y W O R D Sadolescent and young adult, late T cell-mediated rejection, liver transplantation

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Section: Introductionmentioning

confidence: 71%

Section: Methodsmentioning

confidence: 99%

Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation

Takeda

Sakamoto

Irie

et al. 2020

Pediatric Transplantation

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“…L‐BPACR has been showed to be associated with graft loss, decreased liver transplant recipient survival, chronic rejection, and worse prognosis . Because of these critical properties, the identification of biomarkers for predicting l‐BPACR is particularly relevant.…”

Section: Demographic and Clinical Characteristics Of Liver Transplantmentioning

confidence: 99%

“…L-BPACR has been showed to be associated with graft loss, decreased liver transplant recipient survival, chronic rejection, and worse prognosis. 26,27 Because of these critical properties, the identification of biomarkers for predicting l-BPACR is particularly relevant. One study describes elevated blood eosinophil count as a biomarker for predicting l-BPACR, further biomarkers especially genetic biomarkers are unknown.…”

mentioning

confidence: 99%

Impact of TBX21, GATA3, and FOXP3 gene polymorphisms on acute cellular rejection after liver transplantation

Thude

Tiede

Sterneck

et al. 2019

HLA

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The single nucleotide polymorphisms (SNPs) rs4794067, rs2275806, rs2232365, and rs3761548 map in the genes of TBX21, GATA3, and FOXP3 involved in mediating acute cellular rejection. We investigated whether these SNPs are associated with acute cellular liver transplant rejection. The SNPs were analyzed in recipients with early acute cellular rejection (n = 97), recipients with late acute cellular rejection (n = 49), and recipients without rejection (n = 149). There was no association between acute cellular rejection and SNPs rs4794067, rs2275806, and rs2232365. In contrast, the allele −3279A of FOXP3 SNP rs3761548 exhibited a higher frequency in recipients with late acute cellular rejection as compared with recipients without rejection. This result indicates that the allele −3279A of the SNP rs3761548 may predispose to the development of late acute cellular rejection.

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“…According to its clinical properties and pathological/biochemical changes, liver transplant rejection can be divided into early acute, late acute, and chronic cellular [2]. The early acute cellular rejection occurs within one month after liver transplantation [3]. Early diagnosis is very important for prognosis and successful treatment to improve the patient and allograft survival rates [3-5].…”

Section: Introductionmentioning

confidence: 99%

Alterations of Serum IP-10 and TARC in Patients with Early Acute Rejection after Liver Transplantation

Meng¹,

Gao²,

Tang³

et al. 2017

Cell Physiol Biochem

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Background/Aims: To analyze alterations of interferon-γ-induced protein 10 (IP-10) and thymus and activation-regulated chemokine (TARC) levels in early acute liver transplantation rejection. Methods: Thirty-six patients with early acute liver transplantation rejection were classified as non-, mild, moderate, and severe rejection groups. The levels of serum IP-10 and TARC were determined on days 3, 2, 1, and 0 before biopsy. Results: The IP-10 activities in all rejection groups were significantly higher (p < 0.05) than those in the non-rejection group at all time points and correlated with the extent of rejection (p < 0.05). The differences in TARC among the three rejection groups were significant (p < 0.05), and its highest level was found in the mild rejection group at all observed time points, whereas its lowest level was detected in the severe rejection group. The analysis of the TARC/IP-10 ratio revealed that the volume was correlated with the rejection degree. This ratio in the moderate and severe rejection groups on days 2, 1, and 0 before biopsy were 20% lower than that before transplantation. Conclusion: Serum IP-10 showed an increasing trend during early acute liver transplantation rejection. IP-10 increase or TARC/IP-10 ratio decrease combining with abnormal hepatic enzymatic alteration could be a valuable and specific sign for early rejection of the transplanted liver.

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Late Acute Rejection in Liver Transplant: A Systematic Review

Cited by 32 publications

References 11 publications

Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation

Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation

Impact of TBX21, GATA3, and FOXP3 gene polymorphisms on acute cellular rejection after liver transplantation

Alterations of Serum IP-10 and TARC in Patients with Early Acute Rejection after Liver Transplantation

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