Leukoreduction and acute rejection in liver transplantation: An interim analysis

[Guest guest]

doi:10.1016/j.transproceed.2004.07.039

Copyright © 2004 Elsevier Inc. All rights reserved.

Leukoreduction and acute rejection in liver transplantation: An interim

analysis

G.N. Tzimasa, M. Deschenesb, J.S. Barkuna, P. Wongb, J.I. Tchervenkova, H.

Hayatia, E. Alpertb and P. Metrakosa, ,

aDepartment of General Surgery, Section of Transplantation (G.N.T., J.S.B.,

J.I.T., H.H., P.M.)

bDepartment of Medicine, Section of Hepatology (M.D., P.W., E.A.) Montreal,

Quebec, Canada.

Available online 10 September 2004.

Abstract

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).

Conclusion

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.

Supported by the Lois and Byron Dolgin Liver Transplant Fellowship, and by

the Cohen Liver Transplant Fellowship, of the Royal Liver

Transplant Fund.

Address reprint requests to P. Metrakos, MD, Director Hepatic,

Pancreatic and Biliary Surgery 687 Pine Avenue West, S 10.26, Montreal,

Quebec, H3A 1A1

Transplantation Proceedings

Volume 36, Issue 6 , July-August 2004, Pages 1760-1762

[Guest guest]

doi:10.1016/j.transproceed.2004.07.039

Copyright © 2004 Elsevier Inc. All rights reserved.

Leukoreduction and acute rejection in liver transplantation: An interim

analysis

G.N. Tzimasa, M. Deschenesb, J.S. Barkuna, P. Wongb, J.I. Tchervenkova, H.

Hayatia, E. Alpertb and P. Metrakosa, ,

aDepartment of General Surgery, Section of Transplantation (G.N.T., J.S.B.,

J.I.T., H.H., P.M.)

bDepartment of Medicine, Section of Hepatology (M.D., P.W., E.A.) Montreal,

Quebec, Canada.

Available online 10 September 2004.

Abstract

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).

Conclusion

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.

Supported by the Lois and Byron Dolgin Liver Transplant Fellowship, and by

the Cohen Liver Transplant Fellowship, of the Royal Liver

Transplant Fund.

Address reprint requests to P. Metrakos, MD, Director Hepatic,

Pancreatic and Biliary Surgery 687 Pine Avenue West, S 10.26, Montreal,

Quebec, H3A 1A1

Transplantation Proceedings

Volume 36, Issue 6 , July-August 2004, Pages 1760-1762

[Guest guest]

doi:10.1016/j.transproceed.2004.07.039

Copyright © 2004 Elsevier Inc. All rights reserved.

Leukoreduction and acute rejection in liver transplantation: An interim

analysis

G.N. Tzimasa, M. Deschenesb, J.S. Barkuna, P. Wongb, J.I. Tchervenkova, H.

Hayatia, E. Alpertb and P. Metrakosa, ,

aDepartment of General Surgery, Section of Transplantation (G.N.T., J.S.B.,

J.I.T., H.H., P.M.)

bDepartment of Medicine, Section of Hepatology (M.D., P.W., E.A.) Montreal,

Quebec, Canada.

Available online 10 September 2004.

Abstract

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).

Conclusion

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.

Supported by the Lois and Byron Dolgin Liver Transplant Fellowship, and by

the Cohen Liver Transplant Fellowship, of the Royal Liver

Transplant Fund.

Address reprint requests to P. Metrakos, MD, Director Hepatic,

Pancreatic and Biliary Surgery 687 Pine Avenue West, S 10.26, Montreal,

Quebec, H3A 1A1

Transplantation Proceedings

Volume 36, Issue 6 , July-August 2004, Pages 1760-1762

[Guest guest]

doi:10.1016/j.transproceed.2004.07.039

Copyright © 2004 Elsevier Inc. All rights reserved.

Leukoreduction and acute rejection in liver transplantation: An interim

analysis

G.N. Tzimasa, M. Deschenesb, J.S. Barkuna, P. Wongb, J.I. Tchervenkova, H.

Hayatia, E. Alpertb and P. Metrakosa, ,

aDepartment of General Surgery, Section of Transplantation (G.N.T., J.S.B.,

J.I.T., H.H., P.M.)

bDepartment of Medicine, Section of Hepatology (M.D., P.W., E.A.) Montreal,

Quebec, Canada.

Available online 10 September 2004.

Abstract

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).

Conclusion

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.

Supported by the Lois and Byron Dolgin Liver Transplant Fellowship, and by

the Cohen Liver Transplant Fellowship, of the Royal Liver

Transplant Fund.

Address reprint requests to P. Metrakos, MD, Director Hepatic,

Pancreatic and Biliary Surgery 687 Pine Avenue West, S 10.26, Montreal,

Quebec, H3A 1A1

Transplantation Proceedings

Volume 36, Issue 6 , July-August 2004, Pages 1760-1762