Kim Jong Man, Lee Kwang-Woong, Song Gi-Won, Jung Bo-Hyun, Lee Hae Won, Yi Nam-Joon, Kwon ChoonHyuck David, Hwang Shin, Suh Kyung-Suk, Joh Jae-Won, Lee Suk-Koo, Lee Sung-Gyu
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul, Korea.
Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Clin Mol Hepatol. 2016 Sep;22(3):366-371. doi: 10.3350/cmh.2016.0022. Epub 2016 Sep 25.
BACKGROUND/AIMS: The relationship between patient survival and biopsy-proven acute rejection (BPAR) in liver transplant recipients with hepatitis C remains unclear. The aims of this study were to compare the characteristics of patients with and without BPAR and to identify risk factors for BPAR.
We retrospectively reviewed the records of 169 HCV-RNA-positive patients who underwent LT at three centers.
BPAR occurred in 39 (23.1%) of the HCV-RNA-positive recipients after LT. The 1-, 3-, and 5-year survival rates were 92.1%, 90.3%, and 88.5%, respectively, in patients without BPAR, and 75.7%, 63.4%, and 58.9% in patients with BPAR (<0.001). Multivariate analyses showed that BPAR was associated with the non-use of basiliximab and tacrolimus and the use of cyclosporin in LT recipients with HCV RNA-positive.
The results of the present study suggest that the immunosuppression status of HCV-RNA-positive LT recipients should be carefully determined in order to prevent BPAR and to improve patient survival.
背景/目的:丙型肝炎肝移植受者的患者生存率与活检证实的急性排斥反应(BPAR)之间的关系仍不清楚。本研究的目的是比较有和没有BPAR的患者的特征,并确定BPAR的风险因素。
我们回顾性分析了在三个中心接受肝移植的169例HCV-RNA阳性患者的记录。
肝移植后,39例(23.1%)HCV-RNA阳性受者发生了BPAR。无BPAR的患者1年、3年和5年生存率分别为92.1%、90.3%和88.5%,有BPAR的患者分别为75.7%、63.4%和58.9%(<0.001)。多变量分析显示,在HCV RNA阳性的肝移植受者中,BPAR与未使用巴利昔单抗和他克莫司以及使用环孢素有关。
本研究结果表明,应仔细确定HCV-RNA阳性肝移植受者的免疫抑制状态,以预防BPAR并提高患者生存率。