https://pubmed.ncbi.nlm.nih.gov/36581321/ Transplant
Clin Transplant. 2022 Dec 29;e14894.
 doi: 10.1111/ctr.14894. Online ahead of print.
Incidence and risk factors of subclinical rejection after pediatric liver transplantation, and impact on allograft fibrosis
Zhixin Zhang 1,  Shengqiao Zhao  1,  Zhuyuan Si  1,  Zhenglu Wang  2, Chong Dong 2, Chao Sun 2,  Weiping Zheng  2, Wang Kai 2, Wei Zhang 2,  Zhuolun Song  2, Wei
Gao 2, Zhongyang Shen 2
Abstract
Intro: Subclinical rejection (SCR) is a common injury in protocol biopsy after pediatric liver transplantation (pLT), but its effect on the recipient is not clearly understood. We herein investigated the incidence and risk factors involved in SCR and analyzed the relationship between SCR and allograft fibrosis (AF).

Methods: We retrospectively reviewed the biopsy results from 507 children between May 2013 and May 2019, and 352 patients underwent protocol biopsy two years after pLT, 203 underwent protocol biopsy five years after pLT, and 48 underwent protocol biopsy both tw and five years after pLT.

Results: The incidence of SCR in the five-year group was higher than that in the two-year group (20.2%vs.13.4%, respectively, P = 0.033). The number of patients with mild and moderate SCR in the 5-year group was also higher than that in the 2-year group(P = 0.039. Logistic regression analysis showed that acute rejection before liver biopsy and cadaver liver transplantation (DDLT) were independent risk factors for SCR in the two groups, and that the
incidence and severity of AF in protocol biopsies at both periods in the SCR group were higher than those in the non-SCR group (P < 0.05)n

Conclusions: The incidence and severity of SCR increased with the prolongation of protocol biopsy time. We postulate that acute rejection and DDLT are independent risk factors for SCR after transplantation. As the occurrence of SCR also augmented the incidence and severity of AF. This article is protected by copyright. All rights reserved.