J Korean Soc Transplant.  2005 Jun;19(1):51-57.

Allograft Rejection after Liver Transplantation in Children

• Ko JM
• Kim KM
• Kim JS
• Lee SY
• Chang SH
• Choi BH
• Yoo ES
• Ahn CS
• Kim KH
• Hwang S
• Park KM
• Lee YJ
• Lee SG

Abstract

PURPOSE
We performed this study to assess the clinical course of acute rejection and chronic rejection after liver transplantation in children.
METHODS
Seventy-six liver transplantations were performed in 75 children between December 1994 and March 2002. Twenty-five boys and 50 girls were included in this study, and the mean age was 20 months old. We analyzed the incidence, clinical course and outcome of acute and chronic rejection after liver transplantation retrospectively.
RESULTS
Forty out of 75 children (53%) experienced 45 episodes of acute rejection, and 32 episodes (71%) of them occurred within 1 month after transplantation. The degree of acute rejection was mild in 16 (36%), moderate in 14 (31%) and severe in 2 (4%) cases. Younger (<2 years old) recipient experienced higher incidence of acute rejection. But there was no association with recipient's sex, ABO matching, type of donor, and the kind of immunosuppressant. All 40 children with acute rejection improved with conventional treatment. There was no significant statistical relation between acute rejection and recipient's survival. Chronic rejection occurred in 7 (9%) children, and 3 of them died of chronic rejection itself but another 3 children improved during the follow-up periods.
CONCLUSION
Acute rejection occurred in more than half of the pediatric liver transplantation recipients. Most rejection episodes were mild and occurred within 1 month after transplantation. Acute rejection did not affect the recipient's survival and graft function.

Keyword

Liver transplantation; Acute rejection; Chronic rejection; Children

MeSH Terms

Allografts*
Child*
Female
Follow-Up Studies
Humans
Incidence
Infant
Liver Transplantation*
Liver*
Retrospective Studies
Tissue Donors
Transplants