Your browser doesn't support javascript.
loading
Prognostic factors for the evolution and reversibility of chronic rejection in pediatric liver transplantation
Tannuri, Ana Cristina Aoun; Lima, Fabiana; Mello, Evandro Sobroza de; Tanigawa, Ryan Yukimatsu; Tannuri, Uenis.
  • Tannuri, Ana Cristina Aoun; Universidade de São Paulo. Faculdade de Medicina. São Paulo. BR
  • Lima, Fabiana; Universidade de São Paulo. Faculdade de Medicina. São Paulo. BR
  • Mello, Evandro Sobroza de; Universidade de São Paulo. Faculdade de Medicina. São Paulo. BR
  • Tanigawa, Ryan Yukimatsu; Universidade de São Paulo. Faculdade de Medicina. São Paulo. BR
  • Tannuri, Uenis; Universidade de São Paulo. Faculdade de Medicina. São Paulo. BR
Clinics ; 71(4): 216-220, Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-781419
ABSTRACT

OBJECTIVE:

Chronic rejection remains a major cause of graft failure with indication for re-transplantation. The incidence of chronic rejection remains high in the pediatric population. Although several risk factors have been implicated in adults, the prognostic factors for the evolution and reversibility of chronic rejection in pediatric liver transplantation are not known. Hence, the current study aimed to determine the factors involved in the progression or reversibility of pediatric chronic rejection by evaluating a series of chronic rejection cases following liver transplantation.

METHODS:

Chronic rejection cases were identified by performing liver biopsies on patients based on clinical suspicion. Treatment included maintaining high levels of tacrolimus and the introduction of mofetil mycophenolate. The children were divided into 2 groups those with favorable outcomes and those with adverse outcomes. Multivariate analysis was performed to identify potential risk factors in these groups.

RESULTS:

Among 537 children subjected to liver transplantation, chronic rejection occurred in 29 patients (5.4%). In 10 patients (10/29, 34.5%), remission of chronic rejection was achieved with immunosuppression (favorable outcomes group). In the remaining 19 patients (19/29, 65.5%), rejection could not be controlled (adverse outcomes group) and resulted in re-transplantation (7 patients, 24.1%) or death (12 patients, 41.4%). Statistical analysis showed that the presence of ductopenia was associated with worse outcomes (risk ratio=2.08, p=0.01).

CONCLUSION:

The presence of ductopenia is associated with poor prognosis in pediatric patients with chronic graft rejection.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Tacrolimus / Graft Rejection / Immunosuppressive Agents Type of study: Etiology study / Prognostic study / Risk factors Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: English Journal: Clinics Journal subject: Medicine Year: 2016 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Index: LILACS (Americas) Main subject: Tacrolimus / Graft Rejection / Immunosuppressive Agents Type of study: Etiology study / Prognostic study / Risk factors Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: English Journal: Clinics Journal subject: Medicine Year: 2016 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR