Late T cell-mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation.
adolescent and young adult
late T cell-mediated rejection
liver transplantation
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
04
07
2019
revised:
31
01
2020
accepted:
10
03
2020
pubmed:
26
4
2020
medline:
10
8
2021
entrez:
26
4
2020
Statut:
ppublish
Résumé
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 post-treatment biopsy and the need for intensive immunosuppressive therapy.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13708Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Dharnidharka VR, Lamb KE, Zheng J, Schechtman KB, Meier-Kriesche HU. Across all solid organs, adolescent age recipients have worse transplant organ survival than younger age children: a US national registry analysis. Pediatr Transplant. 2015;19(5):471-476.
Kasahara M, Umeshita K, Sakamoto S, et al. Living donor liver transplantation for biliary atresia: an analysis of 2085 cases in the registry of the Japanese Liver Transplantation Society. Am J Transplant. 2018;18(3):659-668.
Shemesh E, Lurie S, Stuber ML, et al. A pilot study of posttraumatic stress and nonadherence in pediatric liver transplant recipients. Pediatrics. 2000;105(2):E29.
Shemesh E, Fine RN. Is calculating the standard deviation of tacrolimus blood levels the new gold standard for evaluating non-adherence to medications in transplant recipients? Pediatr Transplant. 2010;14(8):940-943.
Christina S, Annunziato RA, Schiano TD, et al. Medication level variability index predicts rejection, possibly due to nonadherence, in adult liver transplant recipients. Liver Transpl. 2014;20(10):1168-1177.
Burra P. The adolescent and liver transplantation. J Hepatol. 2012;56(3):714-722.
Shemesh E, Bucuvalas JC, Anand R, et al. The medication level variability index (MLVI) predicts poor liver transplant outcomes: a prospective multi-site study. Am J Transplant. 2017;17(10):2668-2678.
Jadlowiec CC, Morgan PE, Nehra AK, et al. Not all cellular rejections are the same: differences in early and late hepatic allograft rejection. Liver Transpl. 2019;25(3):425-435.
Nacif LS, Pinheiro RS, Pécora RA, et al. Late acute rejection in liver transplant: a systematic review. Arq Bras Cir Dig. 2015;28(3):212-215.
Demetris AJ, Adeyi O, Bellamy CO, et al. Liver biopsy interpretation for causes of late liver allograft dysfunction. Hepatology. 2006;44(2):489-501.
Abraham SC, Freese DK, Ishitani MB, Krasinskas AM, Wu TT. Significance of central perivenulitis in pediatric liver transplantation. Am J Surg Pathol. 2008;32(10):1479-1488.
Pollock-Barziv SM, Finkelstein Y, Manlhiot C, et al. Variability in tacrolimus blood levels increases the risk of late rejection and graft loss after solid organ transplantation in older children. Pediatr Transplant. 2010;14(8):968-975.
Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC. The age of adolescence. Lancet Child Adolesc Health. 2018;2(3):223-228.
Tanaka K, Uemoto S, Tokunaga Y, et al. Surgical techniques and innovations in living related liver transplantation. Ann Surg. 1993;217(1):82-91.
Demetris AJ, Bellamy C, Hübscher SG, et al. 2016 Comprehensive update of the Banff Working Group on liver allograft pathology: introduction of antibody-mediated rejection. Am J Transplant. 2016;16(10):2816-2835.
Kanazawa H, Sakamoto S, Fukuda A, et al. Portal vein reconstruction in pediatric living donor liver transplantation for patients younger than 1 year with biliary atresia. J Pediatr Surg. 2012;47(3):523-527.
Shigeta T, Sakamoto S, Uchida H, et al. Basiliximab treatment for steroid-resistant rejection in pediatric patients following liver transplantation for acute liver failure. Pediatr Transplant. 2014;18(8):860-867.
Narumoto S, Sakamoto S, Sasaki K, et al. ABO-incompatible liver transplantation for children under 2 years of age: a case report and a single-center review. Pediatr Transplant. 2019;23(1):e13308.
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48(3):452-458.
Neil DA, Hubscher SG. Delay in diagnosis: a factor in the poor outcome of late acute rejection of liver allografts. Transplant Proc. 2001;33(1-2):1525-1526.
Ramji A, Yoshida EM, Bain VG, et al. Late acute rejection after liver transplantation: the Western Canada experience. Liver Transpl. 2002;8(10):945-951.
Junge G, Tullius SG, Klitzing V, et al. The influence of late acute rejection episodes on long-term graft outcome after liver transplantation. Transplant Proc. 2005;37(4):1716-1717.
Akamatsu N, Sugawara Y, Tamura S, et al. Late-onset acute rejection after living donor liver transplantation. World J Gastroenterol. 2006;12(41):6674-6677.
Wiesner RH, Steffen BJ, David KM, Chu AH, Gordon RD, Lake JR. Mycophenolate mofetil use is associated with decreased risk of late acute rejection in adult liver transplant recipients. Am J Transplant. 2006;6(7):1609-1616.
Uemura T, Ikegami T, Sanchez EQ, et al. Late acute rejection after liver transplantation impacts patient survival. Clin Transplant. 2008;22(3):316-323.
Thurairajah PH, Carbone M, Bridgestock H, et al. Late acute liver allograft rejection; a study of its natural history and graft survival in the current era. Transplantation. 2013;95(7):955-959.
Ozbilgin M, Egeli T, Unek T, et al. Incidence of late acute rejection in living donor liver transplant patients, risk factors, and the role of immunosuppressive drugs. Transplant Proc. 2015;47(5):1474-1477.
Foster BJ, Dahhou M, Zhang X, Dharnidharka VR, Conway J, Ng VL. High risk of liver allograft failure during late adolescence and young adulthood. Transplantation. 2016;100(3):577-584.
Van Arendonk KJ, King EA, Orandi BJ, et al. Loss of pediatric kidney grafts during the “high-risk age window”: insights from pediatric liver and simultaneous liver-kidney recipients. Am J Transplant. 2015;15(2):445-452.
Kubota T, Hata K, Sozu T, et al. Impact of donor age on recipient survival in adult-to-adult living-donor liver transplantation. Ann Surg. 2018;267(6):1126-1133.
Verthelyi D. Sex hormones as immunomodulators in health and disease. Int Immunopharmacol. 2001;1(6):983-993.
Bouman A, Heineman MJ, Faas MM. Sex hormones and the immune response in humans. Hum Reprod Update. 2005;11(4):411-423.
Shaked A, DesMarais MR, Kopetskie H, et al. Outcomes of immunosuppression minimization and withdrawal early after liver transplantation. Am J Transplant. 2019;19(5):1397-1409.
Fredericks EM, Magee JC, Opipari-Arrigan L, Shieck V, Well A, Lopez MJ. Adherence and health-related quality of life in adolescent liver transplant recipients. Pediatr Transplant. 2008;12(3):289-299.