Vnitřní lékařství 1/2020

PŮVODNÍ PRÁCE Prevalence and risk factors of T-cell mediated rejection in patients after liver transplantation from deceased donors: a retrospective study over 10 years | 7  / Vnitř Lék 2020; 66(E-1): 4–10 /  VNITŘNÍ LÉKAŘSTVÍ www.casopisvnitrnilekarstvi.cz Tab. 2.  Comparison of selected parameters between groups according to T cell mediated rejection occurring among 184 patients after liver transplantation (LTx) fromdeceased donor no rejection n = 163 T cell mediated rejection n = 21 Median IQR Median IQR P Age 54.3 [46.3, 59.8] 42.3 [37.6, 57.7] 0.073 Females (%) 41,1 42,9 1.000 Body mass index 26.06 [23.20, 29.00] 26.17 [23.74, 29.86] 0.708 Aetiology of liver disease: Alcohol (%) 50.9 23.8 0.035 Viral hepatitis (%) 12.9 4.8 0.470 Non-alcoholic fatty liver (%) 11.0 4.8 0.611 Autoimmune hepatitis (%) 6.7 33.3 < 0.001 Primary biliary cholangitis (%) 8.0 14.3 0.579 Primary sclerosing cholangitis (%) 6.7 19.0 0.13 Wilson´s disease (%) 1.8 4.8 0.945 Hepatocellular carcinoma (%) 11.7 0.00 0.204 Cirrhosis severity at liver transplantation Child Pugh score 10.00 [8.00, 11.00] 9.00 [7.00, 11.00] 0.226 MELD score 16.00 [13.69, 19.00] 16.00 [13.00, 17.00] 0.466 INR 1.50 [1.36, 1.66] 1.43 [1.24, 1.65] 0.384 Serum creatinine (μmol/l) 75.00 [61.00, 94.00] 67.00 [55.00, 72.00] 0.020 Serum bilirubin (μmol/l) 50.30 [35.65, 96.50] 64.80 [34.60, 137.70] 0.604 Serum albumin (g/l) 30.00 [26.00, 34.00] 28.00 [26.00, 39.00] 0.711 Presence of ascites pre-LTx (%) 79,5 47.6 0.016 Encephalopathy stage (1–4) (%) 61,5 47,6 0.690 Blood groups 0.841 O (0) 23.3 28.6 A (%) 49.1 47.60 AB (%) 11.7 14.3 B (%) 16.00 9.50 Rhesus factor positive (%) 82.8 90.5 0.562 Liver transplantation Cold ischemia time (minutes) 377 [300, 494] 400 [311-526] 0.649 Day 5 tacrolimus concentration (ng/ml) 5.90 [4.00, 9.30] 4.80 [2.60, 7.00] 0.097 Discharge tacrolimus concentration (ng/ml) 9.00 [6.80, 11.3] 8.9 [7.50, 10.6] 0.670 Length of hospital stay (days) 24.5 [19.0, 33.0] 35.0 [27.8, 47.5] 0.001 Mean follow-up time (months) 41.10 [18.77, 77.03] 17.52 [10.19, 41.56] 0.013 Fig. 1. Overall survival of 193patients undergoing liver transplantationaccor- ding to gender. Dotted line: females, full line: males, P = 0.80 Fig. 2.  Survival probability after liver transplantation according to the occu- rrence of T cell mediated rejection (TCMR). TCMR – dotted line, no-TCMR – full line, P = 0.232 0 10 20 30 40 50 60 70 80 90 100 0 20 40 60 80 100 120 months postLTx Survival probability (%) Numberat risk Group:males 107 71 53 38 28 18 0 Group: females 76 57 36 24 10 2 0 males females 0 10 20 30 40 50 60 70 80 90 100 exitus 0 20 40 60 80 100 120 months postLTx Survival probability (%) Numberat risk Group:no acute cellular rejection 162 118 83 59 37 20 0 Group:acute cellular rejection 21 10 6 3 1 0 0 no acute cellular rejection acute cellular rejection