The incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantation
Background. Chronic graft rejection (CR) represents an increasing concern in pediatric liver transplantation (LT). Risk factors of CR in this population are uncertain. In present study, we aimed to ascertain if clinical parameters could predict the occurrence of CR in LT children.Methods. We retrosp...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | Russian |
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Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2022-01-01
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| Series: | Вестник трансплантологии и искусственных органов |
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| Online Access: | https://journal.transpl.ru/vtio/article/view/1291 |
| _version_ | 1826546329756631040 |
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| author | S. M. Dehghani I. Shahramian M. Ayatollahi F. Parooie M. Salarzaei M. Bahmanyar A. Sargazi M. Delaramnasab |
| author_facet | S. M. Dehghani I. Shahramian M. Ayatollahi F. Parooie M. Salarzaei M. Bahmanyar A. Sargazi M. Delaramnasab |
| author_sort | S. M. Dehghani |
| collection | DOAJ |
| description | Background. Chronic graft rejection (CR) represents an increasing concern in pediatric liver transplantation (LT). Risk factors of CR in this population are uncertain. In present study, we aimed to ascertain if clinical parameters could predict the occurrence of CR in LT children.Methods. We retrospectively analyzed the results from 47 children who had experienced acute hepatic rejection in Namazee hospital, Shiraz, Iran during 2007–2017.Results. Out of 47 children, 22 (46.8%) and 25 (53.2%) were boys and girls respectively. Ascites, gastrointestinal bleeding, and spontaneous bacterial peritonitis were observed in 20 (44.4%), 14 (31.1%), and 4 (9.1%) respectively. Posttransplant vascular and biliary complications were observed in 3 (7%) and 4 (9.3%) cases respectively. The mean time from LT to normalization of liver enzymes was 14.2 ± 7.5 days. The mean of acute rejection episodes was 1.4 ± 0.6 (median = 1 (22, 46.8%), range of 1–3). Six (12.7%) patients experienced CR. The mean time from LT to CR was 75 ± 28.4 days. A significant association was found between CR and patients’ condition (being inpatient or outpatient) before surgery (P = 0.03). No significant relationship was found between CR and post-transplant parameters except for biliary complications (P = 0.01). Both biliary complication (RR = 33.7, 95% CI: 2.2–511, P = 0.01) and inpatient status (RR = 10.9, 95% CI: 1.1–102.5, P = 0.03) significantly increased the risk of CR.Conclusion. Being hospitalized at the time of LT, and development of biliary complications might predict risk factors for development of CR in LT children. |
| first_indexed | 2024-04-10T00:51:26Z |
| format | Article |
| id | doaj.art-fae8e6f492004b77916c4e2d13cbed32 |
| institution | Directory Open Access Journal |
| issn | 1995-1191 |
| language | Russian |
| last_indexed | 2025-03-14T05:32:02Z |
| publishDate | 2022-01-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj.art-fae8e6f492004b77916c4e2d13cbed322025-03-05T14:11:53ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912022-01-01234263110.15825/25/1995-1191-2021-4-26-311046The incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantationS. M. Dehghani0I. Shahramian1M. Ayatollahi2F. Parooie3M. Salarzaei4M. Bahmanyar5A. Sargazi6M. Delaramnasab7Shiraz Organ Transplantation Center, Nemazee Hospital, Shiraz University of Medical SciencesPediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical ScienceShiraz Organ Transplantation Center, Nemazee Hospital, Shiraz University of Medical SciencesPediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical SciencePediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical ScienceFasa University of Medical SciencePediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical SciencePediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical ScienceBackground. Chronic graft rejection (CR) represents an increasing concern in pediatric liver transplantation (LT). Risk factors of CR in this population are uncertain. In present study, we aimed to ascertain if clinical parameters could predict the occurrence of CR in LT children.Methods. We retrospectively analyzed the results from 47 children who had experienced acute hepatic rejection in Namazee hospital, Shiraz, Iran during 2007–2017.Results. Out of 47 children, 22 (46.8%) and 25 (53.2%) were boys and girls respectively. Ascites, gastrointestinal bleeding, and spontaneous bacterial peritonitis were observed in 20 (44.4%), 14 (31.1%), and 4 (9.1%) respectively. Posttransplant vascular and biliary complications were observed in 3 (7%) and 4 (9.3%) cases respectively. The mean time from LT to normalization of liver enzymes was 14.2 ± 7.5 days. The mean of acute rejection episodes was 1.4 ± 0.6 (median = 1 (22, 46.8%), range of 1–3). Six (12.7%) patients experienced CR. The mean time from LT to CR was 75 ± 28.4 days. A significant association was found between CR and patients’ condition (being inpatient or outpatient) before surgery (P = 0.03). No significant relationship was found between CR and post-transplant parameters except for biliary complications (P = 0.01). Both biliary complication (RR = 33.7, 95% CI: 2.2–511, P = 0.01) and inpatient status (RR = 10.9, 95% CI: 1.1–102.5, P = 0.03) significantly increased the risk of CR.Conclusion. Being hospitalized at the time of LT, and development of biliary complications might predict risk factors for development of CR in LT children.https://journal.transpl.ru/vtio/article/view/1291liver transplantationgraft rejectionhost vs graft reaction |
| spellingShingle | S. M. Dehghani I. Shahramian M. Ayatollahi F. Parooie M. Salarzaei M. Bahmanyar A. Sargazi M. Delaramnasab The incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantation Вестник трансплантологии и искусственных органов liver transplantation graft rejection host vs graft reaction |
| title | The incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantation |
| title_full | The incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantation |
| title_fullStr | The incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantation |
| title_full_unstemmed | The incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantation |
| title_short | The incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantation |
| title_sort | incidence and risk factors of chronic rejection in acutely rejected pediatric liver transplantation |
| topic | liver transplantation graft rejection host vs graft reaction |
| url | https://journal.transpl.ru/vtio/article/view/1291 |
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