Leukoreduction and acute rejection in liver transplantation: an interim analysis.
BACKGROUND
Little is known about the effect of blood transfusions and leukoreduction on acute rejection in liver transplantation. The purpose of this study was to assess the impact of leukoreduction on the occurrence of early rejection episodes in liver transplantation.


METHODS
In 1999, mandatory leukoreduction was implemented in our program. Data from 339 consecutive liver transplant recipients were analyzed with attention to the time period as a proxy for leukoreduction, the number of transfusions, the wait list status, the hepatitis B or C status, the recipient age, and the type of immunosuppression.


RESULTS
Using an early (6-month) rejection-free graft survival model, we observed that introduction of leukoreduction was independently associated with fewer rejection episodes (P =.001). Despite the lower rejection rate, due to a regimen of tacrolimus and antithymocyte globulin, the effect of implementation of leukoreduction remained significant (P =.021).


CONCLUSIONS
The use of leukoreduction is associated with fewer early rejections, irrespective of the type of immunosuppression. These data support an exploration of the immunomodulatory effect of leukoreduction.
Tzimas
G N
GN
Department of General Surgery, Section of Transplantation, Montreal, Quebec, Canada.
Deschenes
M
M
Barkun
J S
JS
Wong
P
P
Tchervenkov
J I
JI
Hayati
H
H
Alpert
E
E
Metrakos
P
P
D018572:Disease-Free Survival; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D047589:Leukocyte Reduction Procedures; D016031:Liver Transplantation / Q000276:immunology*; D012189:Retrospective Studies