Liver Transplantation Outcomes Using Anti-Thymocyte Globulin Induction in Patients with Autoimmune Hepatitis.
Transplantation Surgery, Virginia Commonwealth University, Richmond, VA
Meeting: 2017 American Transplant Congress
Abstract number: D215
Keywords: Induction therapy, Infection, Liver transplantation, Rejection
Session Information
Session Name: Poster Session D: Liver: Immunosuppression and Rejection
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: The use of rabbit anti-thymocyte globulin (ATG) induction in high immunological risk patients with autoimmune hepatitis (AIH) could lower the rejection rates after liver transplantation (LTx). Its use may,however, predispose the recipients to a higher risk of infectious complications. We compared Ltx outcomes (survival, rejections and infections) with (ATG+) and without (ATG -) induction in AIH patients.
Methods: Retrospective data analysis of all Ltx performed (1987-2014) for AIH at our center was done. Pediatric recipients and adults with PBC/PSC were excluded. ATG was given on day 0, 1 and 2 (1.5 mg/kg). Wilcoxon test and Chi-squared test were used to compare demographic and categorical variables respectively (p<0.05).
Results: Fifty patients were transplanted for AIH. Recipient demographics for the two groups were comparable.
| Demographics | ATG (n= 17) | No ATG (n=33) | p-value |
| Age (years) | 45.2 ± 16.6 | 41.9 ± 14.4 | ns |
| Males | 13 (76%) | 23 (69%) | ns |
| Caucasian | 10 (59%) | 22 (66%) | ns |
| MELD score | 24 ± 8 | 21 ± 7 | ns |
| Deceased donor Ltx | 12 (70%) | 28 (85%) | ns |
| Cold ischemic time (hrs) | 6.04 ± 4.1 | 7.46 ± 3.7 | ns |
Maintenance immunosuppression in both the groups was similar (not shown). Ltx outcomes are shown below.
| Outcomes after LTx for AIH | ATG (n=17) | No ATG (n=33) | p-value |
| Patient Survival (1-yr) | 82.35 % | 81.82% | ns |
| Graft Survival (Primary) (1-yr) | 82.35 % | 81.82% | ns |
| Re-transplantation (1-yr) | 0 (0%) | 3 (9%) | ns |
| Acute rejections (1-yr) | 6 (35.29%) | 16 (48.48%) | ns |
| Infections (first year) | |||
| Wound | 1 (6%) | 1 (3%) | ns |
| Urinary | 6 (35%) | 10 (30%) | ns |
| Bacteremia | 1 (6%) | 5 (15%) | ns |
| Fungal (any site) | 5 (29%) | 4 (12%) | ns |
| Viral (any) | 6 (35%) | 14 (42%) | ns |
| Clostridium difficile | 2 (12%) | 4 (12%) | ns |
Conclusions: ATG induction in LTx for AIH does not have any adverse impact on patient or graft survival. ATG use was associated with a trend towards fewer acute rejection episodes without any significant increase in risk of post-transplant infectious complications.
CITATION INFORMATION: LeCorchick S, Sharma A, Yakubu I, Bhati C, Reichman T, Kang L, Levy M. Liver Transplantation Outcomes Using Anti-Thymocyte Globulin Induction in Patients with Autoimmune Hepatitis. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
LeCorchick S, Sharma A, Yakubu I, Bhati C, Reichman T, Kang L, Levy M. Liver Transplantation Outcomes Using Anti-Thymocyte Globulin Induction in Patients with Autoimmune Hepatitis. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/liver-transplantation-outcomes-using-anti-thymocyte-globulin-induction-in-patients-with-autoimmune-hepatitis/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress