Acute Liver Allograft Rejection After Living Donor Liver Transplantation: Risk Factors and Patient Survival

Background: Acute rejection (AR) is an important problem after liver transplantation. We aim to evaluate the incidence and risk factors of AR and to identify significant prognostic factors that can influence posttransplant survival in living donor liver transplantation. Methods: A retrospective database of 169 consecutive adult patients who underwent living donor liver transplantation from June 2001 to August 2015 was reviewed. The patients were divided into an AR group and nonAR group. The clinical data of the 2 groups were compared. Results: The median follow-up time for this study was 90.7 months (range: 0.03-124.9 months). Twenty five (14.8%) patients developed AR with a median period of 158 days (3-1,975 days) after transplantation. A multivariate analysis revealed that high posttransplant model for predicting mortality score (hazard ratio, [HR] = 3.462; P = 0.023) was an independent risk factor for AR. Multivariate analysis was used to evaluate factors that influenced the overall survival and revealed that ABO-incompatibility (HR = 2.702; P = 0.01) and patient age >= 50 years (HR = 1.733; P = 0.045) were independent prognostic factors for overall survival after living donor liver transplantation. Conclusions: Higher posttransplant model for predicting mortality score was associated with AR after living donor liver transplantation. ABO-incompatibility and patient age >= 50 years were