oa Wits Journal of Clinical Medicine - Acute cellular rejection in paediatric liver transplants : does a living donor ameliorate the risk of rejection in our patients? A retrospective review at Wits Donald Gordon Medical Centre, South Africa 

Volume 1 Number 3
  • ISSN : 2618-0189
  • E-ISSN: 2618-0197



Background: Despite the enlarging pool of paediatric liver transplants (LT), there is a paucity of data-detailing risk factors for acute cellular rejection (ACR).

To identify risk factors associated with ACR.

Method: We reviewed the data of 98 paediatric patients at Wits Donald Gordon Medical Centre who underwent LT between 2015 and 2018, and subsequent histologically determined ACR.

Results: Of the 98 patients who received a LT, 52% of donors were deceased donors and 48% were living donors. Twenty-two per cent of the patients were diagnosed with ACR during the first 90 days post LT. Sixty-eight per cent of living donor liver transplants were in the shortest (less than 2.5 h) cold ischaemic time (CIT) tertile, while 0% of deceased donor organs were transplanted prior to 2.5 h. We identified decreased CIT and living donor status as factors, both closely related to each other and associated with a decreased risk of ACR.

Conclusion: CIT is associated with a decreased risk of ACR. Living donor LT is associated with a decreased CIT and as a result a less inflammatory milieu in the early post LT period. Further research should be conducted, with particular reference to a decreased risk of ACR in living donor paediatric LT, in order to better inform immunosuppressive therapeutic regimens.

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