Lack of correlation between the magnitude of preservation injury and the incidence of acute rejection, need for OKT3, and conversion to FK506 in cyclosporine-treated primary liver allograft recipients

C. R. Shackleton, Paul Martin, J. Melinek, L. Stothers, J. M. Millis, K. M. Olthoff, D. K. Imagawa, M. Kinkhabwala, S. Rudich, P. Seu, A. Shaked, S. V. McDiarmid, L. I. Goldstein, R. W. Busuttil

Research output: Contribution to journalArticle

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Abstract

In order to study further whether a relationship exists between the extent of ischemia-preservation-reperfusion injury (IPRI) and acute rejection (AR) events in liver allografts, we retrospectively reviewed 213 consecutive cyclosporine-treated patients who received their first liver allograft between 1/1/93 and 12/31/93. Of these, 178 fulfilled the study inclusion criteria. The extent of IPRI was assessed by the peak value of aspartate aminotransferase (ASTmax) observed within the first 72 hr posttransplant. For the purpose of univariate analysis, categorical classification of recipients was done based upon ASTmax asfollows: group 1, ASTmax < 600 IU/L (n=43); group 2, ASTmax 600-2000 IU/L (n=86); and group 3, ASTmax > 2000 IU/L (n=49). For multivariate analysis, stepwise Cox regression was performed with age, ASTmax, and UNOS status as covariates. At a median follow-up of 271 days there were no statistically significant differences between groups with respect to the incidence of a first episode of AR (47%, 55%, 51%, respectively, P=NS), the timing of AR (respective medians, 9, 10, and 10 days, P=NS), or the proportion of patients treated with OKT3 (9%, 20%, 12%, respectively, P=NS) or converted to FK506 (16%, 12%, 10%, P=NS). Cox regression confirmed the lack of an independent association between the extent of IPRI and any of these outcomes. We conclude that in UW-preserved, cyclosporine-treated primary liver allografts, no correlation exists between the extent of IPRI and the incidence, timing, severity, or refractoriness of clinically defined AR events.

Original languageEnglish
Pages (from-to)554-558
Number of pages5
JournalTransplantation
Volume60
Issue number6
StatePublished - Oct 12 1995
Externally publishedYes

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Muromonab-CD3
Tacrolimus
Reperfusion Injury
Cyclosporine
Allografts
Liver
Incidence
Wounds and Injuries
Aspartate Aminotransferases
Multivariate Analysis

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Lack of correlation between the magnitude of preservation injury and the incidence of acute rejection, need for OKT3, and conversion to FK506 in cyclosporine-treated primary liver allograft recipients. / Shackleton, C. R.; Martin, Paul; Melinek, J.; Stothers, L.; Millis, J. M.; Olthoff, K. M.; Imagawa, D. K.; Kinkhabwala, M.; Rudich, S.; Seu, P.; Shaked, A.; McDiarmid, S. V.; Goldstein, L. I.; Busuttil, R. W.

In: Transplantation, Vol. 60, No. 6, 12.10.1995, p. 554-558.

Research output: Contribution to journalArticle

Shackleton, CR, Martin, P, Melinek, J, Stothers, L, Millis, JM, Olthoff, KM, Imagawa, DK, Kinkhabwala, M, Rudich, S, Seu, P, Shaked, A, McDiarmid, SV, Goldstein, LI & Busuttil, RW 1995, 'Lack of correlation between the magnitude of preservation injury and the incidence of acute rejection, need for OKT3, and conversion to FK506 in cyclosporine-treated primary liver allograft recipients', Transplantation, vol. 60, no. 6, pp. 554-558.
Shackleton, C. R. ; Martin, Paul ; Melinek, J. ; Stothers, L. ; Millis, J. M. ; Olthoff, K. M. ; Imagawa, D. K. ; Kinkhabwala, M. ; Rudich, S. ; Seu, P. ; Shaked, A. ; McDiarmid, S. V. ; Goldstein, L. I. ; Busuttil, R. W. / Lack of correlation between the magnitude of preservation injury and the incidence of acute rejection, need for OKT3, and conversion to FK506 in cyclosporine-treated primary liver allograft recipients. In: Transplantation. 1995 ; Vol. 60, No. 6. pp. 554-558.
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abstract = "In order to study further whether a relationship exists between the extent of ischemia-preservation-reperfusion injury (IPRI) and acute rejection (AR) events in liver allografts, we retrospectively reviewed 213 consecutive cyclosporine-treated patients who received their first liver allograft between 1/1/93 and 12/31/93. Of these, 178 fulfilled the study inclusion criteria. The extent of IPRI was assessed by the peak value of aspartate aminotransferase (ASTmax) observed within the first 72 hr posttransplant. For the purpose of univariate analysis, categorical classification of recipients was done based upon ASTmax asfollows: group 1, ASTmax < 600 IU/L (n=43); group 2, ASTmax 600-2000 IU/L (n=86); and group 3, ASTmax > 2000 IU/L (n=49). For multivariate analysis, stepwise Cox regression was performed with age, ASTmax, and UNOS status as covariates. At a median follow-up of 271 days there were no statistically significant differences between groups with respect to the incidence of a first episode of AR (47{\%}, 55{\%}, 51{\%}, respectively, P=NS), the timing of AR (respective medians, 9, 10, and 10 days, P=NS), or the proportion of patients treated with OKT3 (9{\%}, 20{\%}, 12{\%}, respectively, P=NS) or converted to FK506 (16{\%}, 12{\%}, 10{\%}, P=NS). Cox regression confirmed the lack of an independent association between the extent of IPRI and any of these outcomes. We conclude that in UW-preserved, cyclosporine-treated primary liver allografts, no correlation exists between the extent of IPRI and the incidence, timing, severity, or refractoriness of clinically defined AR events.",
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AU - Shackleton, C. R.

AU - Martin, Paul

AU - Melinek, J.

AU - Stothers, L.

AU - Millis, J. M.

AU - Olthoff, K. M.

AU - Imagawa, D. K.

AU - Kinkhabwala, M.

AU - Rudich, S.

AU - Seu, P.

AU - Shaked, A.

AU - McDiarmid, S. V.

AU - Goldstein, L. I.

AU - Busuttil, R. W.

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