Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation
Although poor long‐term graft survival in LT in AYA is recognized, detailed epidemiological data are still lacking. L‐TCMR may have poor outcomes. This study aimed to provide a detailed, epidemiological assessment of the association between AYA age and rejection. L‐TCMR was defined in this study as...
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Veröffentlicht in: | Pediatric transplantation 2020-06, Vol.24 (4), p.e13708-n/a |
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creator | Takeda, Masahiro Sakamoto, Seisuke Irie, Rie Uchida, Hajime Shimizu, Seiichi Yanagi, Yusuke Abdelwahed, Mohamed Sami Fukuda, Akinari Kasahara, Mureo |
description | Although poor long‐term graft survival in LT in AYA is recognized, detailed epidemiological data are still lacking. L‐TCMR may have poor outcomes. This study aimed to provide a detailed, epidemiological assessment of the association between AYA age and rejection. L‐TCMR was defined in this study as TCMR with central vein or perivenular inflammation occurring later than 3 months after LT. A total of 342 patients who survived for at least 3 months after LT between 2005 and 2015 were enrolled. The AYA group (10‐24 years) was compared with the C group (less than 10 years), and the incidence and outcomes of L‐TCMR were analyzed. In total, 342 patients had LT; 38 of these were AYA with the mean follow‐up period of 6.7 years. A total of 304 patients in C group had a mean follow‐up period of 6.3 years (P = .28). The incidence of L‐TCMR in AYA group was significantly higher than in C group (15.8% vs 4.6%, P = .006). The time to L‐TCMR after LT was significantly shorter in AYA group (P = .01). Neither patient survival nor the incidence of non‐adherence differed significantly between the groups (P = .18 and P = .89). The number of additional immunosuppressants after L‐TCMR was significantly higher in the AYA group (P = .04). A high incidence of L‐TCMR was observed in AYA group irrespective of non‐adherence. AYA patients with L‐TCMR should be followed carefully due to the poor results of post‐treatment biopsy and the need for intensive immunosuppressive therapy. |
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L‐TCMR may have poor outcomes. This study aimed to provide a detailed, epidemiological assessment of the association between AYA age and rejection. L‐TCMR was defined in this study as TCMR with central vein or perivenular inflammation occurring later than 3 months after LT. A total of 342 patients who survived for at least 3 months after LT between 2005 and 2015 were enrolled. The AYA group (10‐24 years) was compared with the C group (less than 10 years), and the incidence and outcomes of L‐TCMR were analyzed. In total, 342 patients had LT; 38 of these were AYA with the mean follow‐up period of 6.7 years. A total of 304 patients in C group had a mean follow‐up period of 6.3 years (P = .28). The incidence of L‐TCMR in AYA group was significantly higher than in C group (15.8% vs 4.6%, P = .006). The time to L‐TCMR after LT was significantly shorter in AYA group (P = .01). Neither patient survival nor the incidence of non‐adherence differed significantly between the groups (P = .18 and P = .89). The number of additional immunosuppressants after L‐TCMR was significantly higher in the AYA group (P = .04). A high incidence of L‐TCMR was observed in AYA group irrespective of non‐adherence. AYA patients with L‐TCMR should be followed carefully due to the poor results of post‐treatment biopsy and the need for intensive immunosuppressive therapy.</description><identifier>ISSN: 1397-3142</identifier><identifier>EISSN: 1399-3046</identifier><identifier>DOI: 10.1111/petr.13708</identifier><identifier>PMID: 32333637</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>adolescent and young adult ; Biopsy ; Epidemiology ; Graft rejection ; Immunosuppressive agents ; late T cell–mediated rejection ; Liver transplantation ; Liver transplants ; Lymphocytes T ; Teenagers ; Young adults</subject><ispartof>Pediatric transplantation, 2020-06, Vol.24 (4), p.e13708-n/a</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><rights>2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3578-18ff38e599657f15bab26654a991e29f9ea98b8a85dad8d0878d95ebe44bc6a23</citedby><cites>FETCH-LOGICAL-c3578-18ff38e599657f15bab26654a991e29f9ea98b8a85dad8d0878d95ebe44bc6a23</cites><orcidid>0000-0001-8316-3523 ; 0000-0003-2441-5158 ; 0000-0002-1651-0430 ; 0000-0003-3031-7319 ; 0000-0003-4684-0446</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpetr.13708$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpetr.13708$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32333637$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takeda, Masahiro</creatorcontrib><creatorcontrib>Sakamoto, Seisuke</creatorcontrib><creatorcontrib>Irie, Rie</creatorcontrib><creatorcontrib>Uchida, Hajime</creatorcontrib><creatorcontrib>Shimizu, Seiichi</creatorcontrib><creatorcontrib>Yanagi, Yusuke</creatorcontrib><creatorcontrib>Abdelwahed, Mohamed Sami</creatorcontrib><creatorcontrib>Fukuda, Akinari</creatorcontrib><creatorcontrib>Kasahara, Mureo</creatorcontrib><title>Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation</title><title>Pediatric transplantation</title><addtitle>Pediatr Transplant</addtitle><description>Although poor long‐term graft survival in LT in AYA is recognized, detailed epidemiological data are still lacking. L‐TCMR may have poor outcomes. This study aimed to provide a detailed, epidemiological assessment of the association between AYA age and rejection. L‐TCMR was defined in this study as TCMR with central vein or perivenular inflammation occurring later than 3 months after LT. A total of 342 patients who survived for at least 3 months after LT between 2005 and 2015 were enrolled. The AYA group (10‐24 years) was compared with the C group (less than 10 years), and the incidence and outcomes of L‐TCMR were analyzed. In total, 342 patients had LT; 38 of these were AYA with the mean follow‐up period of 6.7 years. A total of 304 patients in C group had a mean follow‐up period of 6.3 years (P = .28). The incidence of L‐TCMR in AYA group was significantly higher than in C group (15.8% vs 4.6%, P = .006). The time to L‐TCMR after LT was significantly shorter in AYA group (P = .01). Neither patient survival nor the incidence of non‐adherence differed significantly between the groups (P = .18 and P = .89). The number of additional immunosuppressants after L‐TCMR was significantly higher in the AYA group (P = .04). A high incidence of L‐TCMR was observed in AYA group irrespective of non‐adherence. AYA patients with L‐TCMR should be followed carefully due to the poor results of post‐treatment biopsy and the need for intensive immunosuppressive therapy.</description><subject>adolescent and young adult</subject><subject>Biopsy</subject><subject>Epidemiology</subject><subject>Graft rejection</subject><subject>Immunosuppressive agents</subject><subject>late T cell–mediated rejection</subject><subject>Liver transplantation</subject><subject>Liver transplants</subject><subject>Lymphocytes T</subject><subject>Teenagers</subject><subject>Young adults</subject><issn>1397-3142</issn><issn>1399-3046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kc1KHTEYhkNR6k-78QJKwE0RRpNJZpIsi1gtHFDkuA6ZmW9sDjPJNMkoh256D71Dr8Qcj-3ChdkkvDw85PtehI4oOaX5nE2QwillgsgPaJ8ypQpGeL3z8hYFo7zcQwcxrgihNZf8I9pjJWOsZmIf_V6YBHiJWxiGpz9_R-hsDjocYAVtst7h0axx610KtpkzmjyevA_Yz6n1I0RsHTadHyC24FLExnV47Wd3n9N5yMGjTT_xYB8g4BSMi9NgXDIb9Se025shwufX-xDdfb9Ynl8Vi-vLH-ffFkXLKiELKvueSaiUqivR06oxTVnXFTdKUShVr8Ao2Ugjq850siNSyE5V0ADnTVubkh2ir1vvFPyvGWLSo42bgY0DP0ddMsUVyQtUGT1-g678HFz-nS45EYwLLkSmTrZUG3yMAXo9BTuasNaU6E0lelOJfqkkw19elXOT1_sf_ddBBugWeLQDrN9R6ZuL5e1W-gxk35mp</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Takeda, Masahiro</creator><creator>Sakamoto, Seisuke</creator><creator>Irie, Rie</creator><creator>Uchida, Hajime</creator><creator>Shimizu, Seiichi</creator><creator>Yanagi, Yusuke</creator><creator>Abdelwahed, Mohamed Sami</creator><creator>Fukuda, Akinari</creator><creator>Kasahara, Mureo</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8316-3523</orcidid><orcidid>https://orcid.org/0000-0003-2441-5158</orcidid><orcidid>https://orcid.org/0000-0002-1651-0430</orcidid><orcidid>https://orcid.org/0000-0003-3031-7319</orcidid><orcidid>https://orcid.org/0000-0003-4684-0446</orcidid></search><sort><creationdate>202006</creationdate><title>Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation</title><author>Takeda, Masahiro ; Sakamoto, Seisuke ; Irie, Rie ; Uchida, Hajime ; Shimizu, Seiichi ; Yanagi, Yusuke ; Abdelwahed, Mohamed Sami ; Fukuda, Akinari ; Kasahara, Mureo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3578-18ff38e599657f15bab26654a991e29f9ea98b8a85dad8d0878d95ebe44bc6a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>adolescent and young adult</topic><topic>Biopsy</topic><topic>Epidemiology</topic><topic>Graft rejection</topic><topic>Immunosuppressive agents</topic><topic>late T cell–mediated rejection</topic><topic>Liver transplantation</topic><topic>Liver transplants</topic><topic>Lymphocytes T</topic><topic>Teenagers</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takeda, Masahiro</creatorcontrib><creatorcontrib>Sakamoto, Seisuke</creatorcontrib><creatorcontrib>Irie, Rie</creatorcontrib><creatorcontrib>Uchida, Hajime</creatorcontrib><creatorcontrib>Shimizu, Seiichi</creatorcontrib><creatorcontrib>Yanagi, Yusuke</creatorcontrib><creatorcontrib>Abdelwahed, Mohamed Sami</creatorcontrib><creatorcontrib>Fukuda, Akinari</creatorcontrib><creatorcontrib>Kasahara, Mureo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takeda, Masahiro</au><au>Sakamoto, Seisuke</au><au>Irie, Rie</au><au>Uchida, Hajime</au><au>Shimizu, Seiichi</au><au>Yanagi, Yusuke</au><au>Abdelwahed, Mohamed Sami</au><au>Fukuda, Akinari</au><au>Kasahara, Mureo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation</atitle><jtitle>Pediatric transplantation</jtitle><addtitle>Pediatr Transplant</addtitle><date>2020-06</date><risdate>2020</risdate><volume>24</volume><issue>4</issue><spage>e13708</spage><epage>n/a</epage><pages>e13708-n/a</pages><issn>1397-3142</issn><eissn>1399-3046</eissn><abstract>Although poor long‐term graft survival in LT in AYA is recognized, detailed epidemiological data are still lacking. L‐TCMR may have poor outcomes. This study aimed to provide a detailed, epidemiological assessment of the association between AYA age and rejection. L‐TCMR was defined in this study as TCMR with central vein or perivenular inflammation occurring later than 3 months after LT. A total of 342 patients who survived for at least 3 months after LT between 2005 and 2015 were enrolled. The AYA group (10‐24 years) was compared with the C group (less than 10 years), and the incidence and outcomes of L‐TCMR were analyzed. In total, 342 patients had LT; 38 of these were AYA with the mean follow‐up period of 6.7 years. A total of 304 patients in C group had a mean follow‐up period of 6.3 years (P = .28). The incidence of L‐TCMR in AYA group was significantly higher than in C group (15.8% vs 4.6%, P = .006). The time to L‐TCMR after LT was significantly shorter in AYA group (P = .01). Neither patient survival nor the incidence of non‐adherence differed significantly between the groups (P = .18 and P = .89). The number of additional immunosuppressants after L‐TCMR was significantly higher in the AYA group (P = .04). A high incidence of L‐TCMR was observed in AYA group irrespective of non‐adherence. AYA patients with L‐TCMR should be followed carefully due to the poor results of post‐treatment biopsy and the need for intensive immunosuppressive therapy.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32333637</pmid><doi>10.1111/petr.13708</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8316-3523</orcidid><orcidid>https://orcid.org/0000-0003-2441-5158</orcidid><orcidid>https://orcid.org/0000-0002-1651-0430</orcidid><orcidid>https://orcid.org/0000-0003-3031-7319</orcidid><orcidid>https://orcid.org/0000-0003-4684-0446</orcidid></addata></record> |
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subjects | adolescent and young adult Biopsy Epidemiology Graft rejection Immunosuppressive agents late T cell–mediated rejection Liver transplantation Liver transplants Lymphocytes T Teenagers Young adults |
title | Late T cell–mediated rejection may contribute to poor outcomes in adolescents and young adults with liver transplantation |
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