Comparison of acute cellular rejection between living donor liver transplantation and cadaveric liver transplantation

Abstract

OBJECTIVE: To compare the incidence and severity of acute cwellular rejection (ACR) between living donor liver transplantation (LDLT) and cadaveric liver transplantation (CLT). METHODS: 51 patients underwent LDLT among which 30 received the liver of blood-related donors, and 65 patients underwent CLT. Clinical data, such as the cold ischemic time of liver graft, use of immunosuppressive agents, ACR rate, response to steroid therapy, HLA matching between donor and recipient, and survival rates of liver graft and patients were collected and analyzed. RESULTS: The graft survival rate, patient survival rate, ACR rate, ACR multiple incidence rate, and no response rate to steroid therapy in CLT and LDLT groups were 72% vs 78%, 77% vs. 78%, 48% vs. 41%, 20% vs. 10%, and 11% vs. 4% (P > 0.05). The difference of ACR rates between CLT and living blood-related donor liver transplantation was statistically insignificant. There was no significant difference in number of HLA allele mismatching between patients with ACR and those without ACR. The combined immunosuppression therapy rely mainly on FK506 use reduced the occurrence of ACR (P < 0.05). CONCLUSION: There is no marked difference in incidence of ACR between LDLT and CLT. ACR in liver transplantation is correlated to neither HLA matching between donors and recipients nor to cold ischemic time of the liver graft. FK506 avoids ACR better than cyclosporin2 A.