RT Journal Article
T1 An objective definition for clinical suspicion of T-cell-mediated rejection after liver transplantation
A1 Rodriguez-Peralvarez, Manuel
A1 De Luca, Laura
A1 Crespo, Gonzalo
A1 Rubin, Angel
A1 Marin, Sandra
A1 Benlloch, Salvador
A1 Colmenero, Jordi
A1 Berenguer, Marina
A1 Navasa, Miguel
A1 Tsochatzis, Emmanuel
A1 De la Mata, Manuel
K1 Immunosuppression
K1 Liver biopsy
K1 Liver transplantation
K1 T-cell-mediated rejection
K1 Allograft-rejection
K1 Free immunosuppression
K1 Organ-transplantation
K1 Ifn-gamma
K1 Risk
K1 Recipients
K1 Tacrolimus
K1 Biomarkers
K1 Diagnosis
K1 Therapy
AB 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; P4 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 (PP<.001 in both comparisons). In conclusion, increased serum bilirubin, rising bilirubin and eosinophilia are validated risk factors for moderate-severe histological TCMR and could be used as  objective criteria to select candidates for liver biopsy.
PB Wiley-Blackwell Publishing, Inc.
SN 0902-0063
YR 2017
FD 2017-05-07
LK http://hdl.handle.net/10668/18984
UL http://hdl.handle.net/10668/18984
LA en
NO Rodríguez-Perálvarez M, De Luca L, Crespo G, Rubin Á, Marín S, Benlloch S, et al. An objective definition for clinical suspicion of T-cell-mediated rejection after liver transplantation. Clin Transplant. 2017 Jul;31(7)
DS RISalud
RD Apr 12, 2025