C. S. Hwang1, S. Levea2, M. MacConmara1 1UT Southwestern Medical Center,Surgery,Dallas, TX, USA 2UT Southwestern Medical Center,Medicine,Dallas, TX, USA
Introduction:
The variable of donor and recipient age in relation to rejection in liver transplantation has not been well studied. We were interested if donor and recipient age affect the rates of rejection in liver transplant recipients.
Methods:
We queried the United Network for Organ Sharing database for all patients who underwent liver transplantation from 1996 to 2017. The patients were divided by adult and pediatric (< 18 years) status. Donor and recipient demographic data were examined, rejection episodes within the first year were examined (early rejection), and patient and allograft survival were calculated. Categorical differences were compared using the unpaired Student's t-test and nominal variables using either the Chi Square or Fischer's exact test. A p-value of <0.05 was considered significant.
Results:
154,113 patients underwent liver transplantation during this time period, and 16,355 were pediatric recipients. 16,121 (11.7%) adult patients had an early rejection episode while 3,121 (19.1%) pediatric patients had an early rejection episode (p<0.001). When examined based upon donor age, patients receiving liver allografts from pediatric donors (15.6%) had a significantly higher rejection rate than those who received allografts from adult donors (11.8%) (p<0.001). Pediatric patients who received pediatric allografts with rejection had significantly poorer allograft survival than similar patients without rejection (p<0.001, Graph 1).
Conclusion:
Pediatric patients who receive organs from pediatric donors are at higher risk of developing early rejection episodes. This transplant recipient population should undergo induction immunosuppression to decrease the risk of rejection in the early post-operative period and improve allograft survival.
