title: Incidence of Late Acute Rejection in Living Donor Liver Transplant Patients, Risk Factors, and the Role of Immunosuppressive Drugs.
abstract: BACKGROUND
  Late acute rejection (LAR) is a clinical manifestation that occurs 6 months after liver transplantation, shows histopathologic features different from those of acute rejection, and is the cause of a high prevalence of morbidity and mortality.
  
  
  METHODS
  In this study, hospital records of 211 living donor liver transplantation (LDLT) patients who underwent surgery in our clinic between June 2000 and February 2014 were reviewed retrospectively. The patients were ≥ 18 years old and were followed for ≥ 6 months.
  
  
  RESULTS
  Of the 211 patients, 21 (9.9%; 16 males, 5 females) developed LAR. The mean age of the patients was 46 years (range, 33-58). The mean follow-up period was 61.2 months (range, 6-152) and the median time to development of LAR was 26.4 months (range, 7-77). In our study, patients who received cyclosporine and mycophenolate mofetil (MMF) treatment developed more LAR than did patients who received tacrolimus and MMF therapy (P = .05). In addition, the incidence of LAR in patients who underwent LDLT was significantly greater in the ABO-matched groups than in the ABO identical group (P = .028).
  
  
  CONCLUSIONS
  Development of LAR and serious complications related to it can be avoided if liver transplant recipients are followed regularly and closely in outpatient clinics after transplantation.
authors.affiliation: Department of General Surgery, Hepatopancreatobiliary Surgery and Liver Transplantation Unit, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey. Electronic address: mucahitozbilgin@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Ozbilgin
authors.affiliation: Department of General Surgery, Hepatopancreatobiliary Surgery and Liver Transplantation Unit, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Egeli
authors.affiliation: Department of General Surgery, Hepatopancreatobiliary Surgery and Liver Transplantation Unit, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Unek
authors.affiliation: Deparment of Anesthesiology, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Ozkardesler
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey.
authors.forename: V
authors.initials: V
authors.lastname: Avkan-Oguz
authors.affiliation: Department of Pathology, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Sagol
authors.affiliation: Deparment of Anesthesiology, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Ozbilgin
authors.affiliation: Department of General Surgery, Hepatopancreatobiliary Surgery and Liver Transplantation Unit, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Bacakoglu
authors.affiliation: Department of General Surgery, Hepatopancreatobiliary Surgery and Liver Transplantation Unit, Inciralti Dokuz Eylul University Medical Faculty, Inciralti, Izmir, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Astarcıoglu
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D007166:Immunosuppressive Agents