期刊
TRANSPLANTATION
卷 69, 期 11, 页码 2330-2336出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00007890-200006150-00019
关键词
-
资金
- NIAAA NIH HHS [A-3176] Funding Source: Medline
- NIAID NIH HHS [R01AI38899-01A2] Funding Source: Medline
- NIDDK NIH HHS [1RO1DK49615-O1A1, R01 DK049615] Funding Source: Medline
Background, Predisposing factors, long-term occurrence, and histopathological changes associated with recovery or progression to allograft failure from chronic rejection (CR) were studied in adult patients treated primarily with tacrolimus. Methods. CR cases were identified using stringent criteria applied to a retrospective review of computerized clinicopathological data and slides. Results, After 1973 days median follow-up, 35 (3.3%) of 1049 primary liver allograft recipients first developed CR between 16 and 2532 (median 242) days. The most significant risk factors for CR were the number (P<0.001) and histological severity (P<0.005) of acute rejection episodes and donor age >40 years (P<0.03). Other demographic and matching parameters were not associated with CR in this cohort, Ten patients died with, but not of, CR, Eight required retransplantation because of CR at a median of 268 days. Ten resolved either histologically or by normalization of liver injury tests over a median of 548 days. CR persisted for 340 to 2116 days in the remaining seven patients. More extensive bile duct loss (P<0.01), small arterial loss (P<0.03), foam cell clusters (P<0.01) and higher total bilirubin (P<0.02) and aspartate aminotransferase (P<0.03) were associated with allograft failure from CR. Conclusions. Early chronic liver allograft rejection is potentially reversible and a combination of histological, clinical, and laboratory data can be used to stage CR. Unique immunological and regenerative properties of liver allografts, which lead to a low incidence and reversibility of early CB, can provide insights into transplantation biology.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据