An objective definition for clinical suspicion of T-cell-mediated rejection after liver transplantation

Autor: Salvador Benlloch, Jordi Colmenero, Gonzalo Crespo, Angel Rubín, Manuel de la Mata, Laura De Luca, Sandra Marín, Manuel Rodríguez-Perálvarez, Emmanuel Tsochatzis, Marina Berenguer, Miguel Navasa
Přispěvatelé: [Rodriguez-Peralvarez, Manuel] Reina Sofia Univ Hosp, Dept Hepatol & Liver Transplantat, IMIBIC, CIBERehd, Cordoba, Spain, [Marin, Sandra] Reina Sofia Univ Hosp, Dept Hepatol & Liver Transplantat, IMIBIC, CIBERehd, Cordoba, Spain, [De la Mata, Manuel] Reina Sofia Univ Hosp, Dept Hepatol & Liver Transplantat, IMIBIC, CIBERehd, Cordoba, Spain, [De Luca, Laura] Royal Free Hosp, UCL Inst Liver & Digest Hlth, London, England, [Tsochatzis, Emmanuel] Royal Free Hosp, UCL Inst Liver & Digest Hlth, London, England, [De Luca, Laura] Royal Free Hosp, Sheila Sherlock Liver Unit, London, England, [Tsochatzis, Emmanuel] Royal Free Hosp, Sheila Sherlock Liver Unit, London, England, [De Luca, Laura] UCL, London, England, [Tsochatzis, Emmanuel] UCL, London, England, [Crespo, Gonzalo] CIBERehd, IDIBAPS, Liver Transplant Unit, Hosp Clin, Barcelona, Spain, [Colmenero, Jordi] CIBERehd, IDIBAPS, Liver Transplant Unit, Hosp Clin, Barcelona, Spain, [Navasa, Miguel] CIBERehd, IDIBAPS, Liver Transplant Unit, Hosp Clin, Barcelona, Spain, [Rubin, Angel] La Fe Univ Hosp, Hepatol & Liver Transplantat Unit, CIBERehd, Valencia, Spain, [Benlloch, Salvador] La Fe Univ Hosp, Hepatol & Liver Transplantat Unit, CIBERehd, Valencia, Spain, [Berenguer, Marina] La Fe Univ Hosp, Hepatol & Liver Transplantat Unit, CIBERehd, Valencia, Spain
Rok vydání: 2017
Předmět:
Graft Rejection
Male
T-Lymphocytes
medicine.medical_treatment
Organ-transplantation
030230 surgery
Liver transplantation
Gastroenterology
law.invention
chemistry.chemical_compound
Postoperative Complications
0302 clinical medicine
Randomized controlled trial
Risk Factors
law
Diagnosis
Eosinophilia
T-cell-mediated rejection
immunosuppression
medicine.diagnostic_test
liver transplantation
Graft Survival
Allograft-rejection
Middle Aged
Prognosis
medicine.anatomical_structure
Liver biopsy
Cohort
Female
030211 gastroenterology & hepatology
medicine.symptom
Risk
Adult
medicine.medical_specialty
Bilirubin
T cell
Tacrolimus
03 medical and health sciences
Internal medicine
medicine
Humans
Free immunosuppression
Derivation
liver biopsy
Retrospective Studies
Transplantation
business.industry
Liver Transplantation
Surgery
chemistry
Recipients
Therapy
business
Ifn-gamma
Biomarkers
Follow-Up Studies
Zdroj: CLINICAL TRANSPLANTATION
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
instname
ISSN: 0902-0063
Popis: A uniform definition of clinical suspicion of T-cell-mediated rejection (TCMR) in liver transplantation (LT) is needed to homogenize clinical decisions, especially within randomized trials. This multicenter study included a total of 470 primary LT recipients. The derivation cohort consisted of 142 patients who had clinically driven liver biopsies at any time after LT. The external validation cohort included 328 patients who underwent protocol biopsies at day 7-10 after LT. The rates of moderate-severe histological TCMR were 33.8% in the derivation cohort and 43.6% in the validation cohort. Independent predictors (ie, risk factors) of moderate-severe TCMR in the derivation cohort were as follows: serum bilirubin >4 mg/dL (OR=5.83; P0.1x10(9)/L (OR=3.81; P=.004). In the validation cohort, the number of risk factors was an independent predictor of moderate-severe TCMR (OR=1.74; P=.001), after controlling for hepatitis C status. The number of risk factors paralleled the rates of moderate-severe TCMR in the derivation and validation cohorts (P
Databáze: OpenAIRE
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