Predictors of long-term outcome after liver transplant

Rook, Michelle; Rand, Elizabeth B.

doi:10.1097/mot.0b013e32834a945d

Cited by 20 publications

(17 citation statements)

References 42 publications

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“…Immune system elicits complex and aggressive reaction post-transplantation, which even destroys the graft [1], [2]. Although the total incidence of allograft rejection decreases dramatically due to immunosuppressive therapies [3], acute rejection episodes still occur among 15–45% recipients within several months, which leads to higher incidence of chronic organ dysfunction and suboptimal long-term outcomes [3].…”

Section: Introductionmentioning

confidence: 99%

Genetic Polymorphism of Interferon Regulatory Factor 5 (IRF5) Correlates with Allograft Acute Rejection of Liver Transplantation

Wei

Dai

et al. 2014

PLoS ONE

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BackgroundAlthough liver transplantation is one of the most efficient curative therapies of end stage liver diseases, recipients may suffer liver graft loss opst-operation. IRF-5, a member of Interferon Regulatory Factors, functions as a key regulator in TLR4 cascade, and is capable of inducing inflammatory cytokines. Although TLR4 has been proved to contribute to acute allograft rejection, including after liver transplantation, the correlation between IRF5 gene and acute rejection has not been elucidated yet.MethodsThe study enrolled a total of 289 recipients, including 39 females and 250 males, and 39 recipients developed acute allograft rejection within 6 months post-transplantation. The allograft rejections were diagnosed by liver biopsies. Genome DNA of recipients was extracted from pre-operative peripheral blood. Genotyping of IRF-5, including rs3757385, rs752637 and rs11761199, was performed, followed by SNP frequency and Hardy-Weinberg equilibrium analysis.ResultsThe genetic polymorphism of rs3757385 was found associated with acute rejection. G/G homozygous individuals were at higher risk of acute rejection, with a P value of 0.042 (OR = 2.34 (1.07–5.10)).ConclusionsIRF5, which transcriptionally activates inflammatory cytokines, is genetically associated with acute rejection and might function as a risk factor for acute rejection of liver transplantations.

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Section: Introductionmentioning

confidence: 99%

Genetic Polymorphism of Interferon Regulatory Factor 5 (IRF5) Correlates with Allograft Acute Rejection of Liver Transplantation

Wei

Dai

et al. 2014

PLoS ONE

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“…Currently patients long-term survival rates are reported to be between 85% and 90% [1]. The possibility of prolonging recipient life expectancy has triggered several studies focusing not only on physical problems but also on psychological and psychosocial outcomes.…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in pediatric liver transplanted patients compared with a chronic liver disease group

et al. 2013

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BackgroundAchieving a good health-related quality of life (HRQoL) is currently one of the main aims in long term survival of liver transplanted children (PLT). Purpose of our study is to compare HRQoL of PLT patients (N = 33, mean age 12.8 y) vs. sex and age matched patients with compensated and clinically stable chronic liver disease (CLD) (N = 25, mean age 11.9 y).MethodsHRQoL was measured from both patient and parental perspectives using the CHQ-CF87 and CHQ-PF50 questionnaires, respectively.ResultsGeneral Health Perception scores of PLT subjects resulted significantly lower than those of CLD both at self- and parental report (p < 0.05 and p < 0.01, respectively). No other significant differences in other HRQoL domains were found between groups.ConclusionOur results suggest that the two populations are quite similar regarding HRQoL, but both parents and children of PLT group perceive a worse general health. Further studies are needed to confirm these results.

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“…Moreover, BCS has been thought to negatively affect graft and patient survival . However, the overall survival rate of the BCS patients in this study was not inferior to the overall survival rate of general liver transplant recipients . Appropriate management for biliary casts and combined biliary infections would compensate for reduced survival.…”

Section: Discussionmentioning

confidence: 62%

Long-term clinical outcomes of biliary cast syndrome in liver transplant recipients

et al. 2013

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Biliary cast syndrome (BCS) is an uncommon complication of orthotopic liver transplantation (OLT), so the long-term treatment outcomes of BCS are not well characterized. The purpose of this study was to evaluate the long-term treatment outcomes and prognosis of BCS after OLT. The medical records of 1097 patients who underwent OLT from January 2000 to September 2009 were reviewed. Those patients who had BCS were evaluated with respect to the treatment method, overall survival and relapse rates, and relapse-free time. Twenty-three patients (2.1%) were diagnosed with BCS with a mean overall follow-up of 59.9 months. All the patients had benign biliary strictures and repeatedly underwent balloon dilatation by an endoscopic or percutaneous approach. Primary biliary cast removal was tried with the endoscopic method from 11 patients and with the percutaneous methods from 12 patients. Casts were completely removed by repetitive procedures in 22 patients, but BCS relapsed in 12 patients (55%). Persistent biliary strictures were significantly associated with the BCS relapse frequency (0.37 versus 0.05 times per year, P 5 0.006). The 5-year overall survival rate for BCS patients after OLT was 87%. The risk factors associated with early relapse were female sex, hepatic artery stenosis, and acute cellular rejection. In a multivariate analysis, acute cellular rejection was the only significant risk factor for early relapse (hazard ratio 5 11.1, 95% confidence interval 5 1.9-63.2, P 5 0.007). In conclusion, patients with BCS frequently relapse, and multiple interventions and the treatment of biliary strictures are needed. Acute cellular rejection after OLT is a significant risk factor for early relapse.

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Predictors of long-term outcome after liver transplant

Cited by 20 publications

References 42 publications

Genetic Polymorphism of Interferon Regulatory Factor 5 (IRF5) Correlates with Allograft Acute Rejection of Liver Transplantation

Genetic Polymorphism of Interferon Regulatory Factor 5 (IRF5) Correlates with Allograft Acute Rejection of Liver Transplantation

Health-related quality of life in pediatric liver transplanted patients compared with a chronic liver disease group

Long-term clinical outcomes of biliary cast syndrome in liver transplant recipients

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