Parameters that may indicate early postoperative rejections in patients with liver transplantation.

Abstract

Aim: We aimed to investigate the importance of inflammatory parameters in determining acute rejection in the early post-operative period in liver transplant client. Materials and Methods: When rejection was developed and after pulse steroid therapy, Preoperative, Hemoglobin, Neutrophil / Lymphocyte rate, AST / Lymphocyte rate, AST / Neutrophil rate, ALT / Lymphocyte rate, ALT / Neutrophil rate, CRP / Albumin rate, Glucose, tacrolimus and GRWR (Graft recipient weight ratio) levels of clients who developed rejection in the early period after liver transplantation performed Yeditepe University Hospital in 2020 were measured. Preoperative and discharge values of the group without rejection were also evaluated. Results: Acute rejection developed in the first one month in the early postoperative period at eight (23.5%) of 34 clients who underwent liver transplantation. It was observed that there were significant differences in terms of changes in ALT and AST values at different stages of treatment in clients who developed rejection (p=0.01). The preoperative albumin value of the clients who developed rejection was significantly lower than the clients who did not develop rejection (p=0.040). The difference among pre-transplantation CRP values was significant (p = 0.035). In the multiple analyzes performed, the ratio of neutrophil/lymphocyte (p=0.026), AST/lymphocyte (p=0.003), ALT/lymphocyte (p<0.001) and ALT/neutrophil (p=0.003) at the rejection stage according to the pre-transplantation period was significant. Conclusion: Acute rejection can occur days after transplantation and may lead to graft failure. The importance of parameters that supports the correct diagnosis in treatment is increasing day by day.

Keywords

• karaciğer transplantasyonu
• rejeksiyon
• immünosüpresyon
• liver transplantation
• rejection
• immunosuppression