Low‐dose aspirin confers protection against acute cellular allograft rejection after primary liver transplantation

Abstract

This study investigated the effect of low-dose aspirin in primary adult liver transplantation (LT) on acute cellular rejection (ACR) as well as arterial patency rates. The use of low-dose aspirin after LT is practiced by many transplant centers to minimize the risk of hepatic artery thrombosis (HAT), although

What is the optimal management of thromboprophylaxis after liver transplantation regarding prevention of bleeding, hepatic artery, or portal vein thrombosis? A systematic review of the literature and expert panel recommendations

“…The retrospective multicenter study by Oberkofler et al. examined the effect of aspirin on the incidence of HAT in 2,366 LT recipients (ASA, n = 1436; no ASA, n = 930) 34 . Aspirin was beneficial in lowering the risk of HAT (within 1 year post‐transplant, Hazard Ratio .23; 95% CI: .13–.4; p < .001), but the benefit did not extend to the later incidence (>1 year) of HAT 34 .…”

“…34 Aspirin was beneficial in lowering the risk of HAT (within 1 year post-transplant, Hazard Ratio .23; 95% CI: .13-.4; p < .001), but the benefit did not extend to the later incidence (>1 year) of HAT. 34 In contrast, Vivarelli et al found that the administration of aspirin decreased the overall late HAT from 2.2% to .4% (p = .037) and the recipients of DCD livers or in need of the arterial conduit during the reconstruction had significantly higher rate of HAT if aspirin prophylaxis was not used. 31 Wolf et al compared the incidence of HAT in the group of 529 adult and pediatric recipients with and without post-operative aspirin prophylaxis (81 mg for adults and 40 mg for children).…”

Letter: what explains improved survival from statin exposure after liver transplantation?

“…Oberkofler et al recently found that low-dose aspirin protects against acute cellular rejection and hepatic artery thrombosis, translating to improved graft and patient survival rates. 5 Therefore, the betweengroup differences might be partly attributable to aspirin use. Thus, whether statins have an independent favourable impact on post-LT outcomes merits debate.…”

Letter: what explains improved survival from statin exposure after liver transplantation? Authors' reply

“…The second point they raised concerned the concomitant use of aspirin as a possible confounding factor in improving survival. They cited the study by Oberkofler et al, 3 in which showed that aspirin was associated with a lower risk of acute rejection and hepatic artery thrombosis after liver transplant (LT), improving graft and overall survival.…”