Date: Tuesday, May 2, 2017
Session Name: Poster Session D: Liver: Immunosuppression and Rejection
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 April 2, 2020.
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