CHRONIC LIVER ALLOGRAFT REJECTION IN A POPULATION TREATED PRIMARILY WITH TACROLIMUS AS BASELINE IMMUNOSUPPRESSION

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Abstract
Background. Predisposing factors, long-term occurrence, and histopathological changes associated with recovery or progression to allograft failure from chronic rejection (CR) were studied in adult patients treated primarily with tacrolimus. Methods. CR cases were identified using stringent criteria applied to a retrospective review of computerized clinicopathological data and slides. Results. After 1973 days median follow-up, 35 (3.3%) of 1049 primary liver allograft recipients first developed CR between 16 and 2532 (median 242) days. The most significant risk factors for CR were the number (P P 40 years (P P P P P P <0.03) were associated with allograft failure from CR. Conclusions. Early chronic liver allograft rejection is potentially reversible and a combination of histological, clinical, and laboratory data can be used to stage CR. Unique immunological and regenerative properties of liver allografts, which lead to a low incidence and reversibility of early CR, can provide insights into transplantation biology.