Prediction of acute cellular rejection by peripheral blood eosinophilia in pediatric living donor liver transplantation.

Abstract

BACKGROUND:

Acute cellular rejection (ACR) is a common cause of morbidity following liver transplantation. Several reports have evaluated the predictive value of peripheral blood eosinophilia as a simple noninvasive diagnostic marker for ACR. This study examined whether the relative eosinophil counts (REC) predicted ACR in pediatric living donor liver transplantation (LDLT).

METHODS:

One hundred three patients underwent LDLT between May 2001 and December 2007. ACR were diagnosed based on the pathological findings.

RESULTS:

The incidence of ACR was 46.6% (48/103); ACR was diagnosed an average of 13.5 days after LDLT. The average REC at 4 and 2 days before the onset ACR (n = 39) within 30 postoperative day (POD) was 4.3% and 7.3%, respectively, and 9.0% at the onset. Patients with ACR showed significantly higher levels of REC compared with those free of ACR (P = .039). REC thresholds of 10% at POD 7 displayed a sensitivity and specificity of ACR detection of 80% and 75%, respectively. Moreover, the accumulated morbidity ratio of ACR within 30 POD was significantly higher with REC >10% at POD 7 (P = .007).

CONCLUSION:

ACR within POD 30 should be considered when REC is >10% at POD 7 after LDLT.

• Authors: Y Sanada, K Ushijima, K Mizuta, T Urahashi, Y Ihara, T Wakiya, N Okada, N Yamada, S Egami, S Hishikawa, S Otomo, K Sakamoto, Y Yasuda, H Kawarasaki
• Journal: Transplantation proceedings (Transplant Proc) Vol. 44 Issue 5 Pg. 1341-5 (Jun 2012) ISSN: 1873-2623 [Electronic] United States
• PMID: 22664012 (Publication Type: Journal Article)
• Copyright: Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

Topics

• Acute Disease
• Adolescent
• Analysis of Variance
• Child
• Child, Preschool
• Eosinophilia (blood, diagnosis, etiology)
• Female
• Graft Rejection (diagnosis, immunology)
• Humans
• Immunity, Cellular
• Infant
• Japan
• Liver Transplantation (adverse effects, immunology)
• Living Donors
• Male
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Severity of Illness Index
• Time Factors
• Treatment Outcome