Late-onset acute rejection after living donor liver transplantation

Table 1 Target trough levels of calcineurin inhibitors and steroid dosage

Postoperativetime (d)	Tacrolimus(μg/L)	Cyclosporine(μg/L)	Methylprednisolone(mg/kg daily)
1-7	15-20	300-350	20-0.75
8-14	14-16	250-300	0.5-0.3
15-90	10-15	200-250	0.3-0.12
91-180	8-10	150-200	0.08-0.12
180-	5-10	100-150	0.05

Table 2 Incidence of LAR for selected baseline factors

Factors	Variables (n)	% LAR	P
Preoperative
Age (yr)	< 40 (53) vs ≥ 40 (151)	12 vs 6	0.03
Gender	Men (102) vs women (102)	8 vs 8	0.79
Disease: Viral	Yes (77) vs No (127)	9 vs 6	0.41
Total bilirubin (mg/L)	< 50 (100) vs ≥ 50 (104)	8 vs 7	0.72
MELD score	< 10 (123) vs ≥ 10 (81)	7 vs 9	0.57
Blood type match	Identical (163) vs compatible (41)	8 vs 5	0.5
Gender match	Yes (91) vs No (113)	9 vs 6	0.48
Donor age (yr)	< 40 (84) vs ≥ 40 (120)	10 vs 6	0.32
HLA-A mismatch (n)	0 (75) vs 1 or 2 (128)	9 vs 6	0.64
HLA-B mismatch (n)	0 (38) vs 1 or 2 (166)	11 vs 7	0.41
HLA-DR mismatch (n)	0 (43) vs 1 or 2 (161)	5 vs 8	0.44
T-LCX	Negative (195) vs positive (9)	8 vs 0	0.39
B-LCX	Negative (116) vs positive (88)	5 vs 7	0.71
Operative
Anhepatic time (min)	< 150 (116) vs ≥ 150 (88)	8 vs 7	0.8
Blood loss (mL/kg)	< 100 (88) vs ≥ 100 (116)	7 vs 8	0.8
Graft weight/SLV (%)	< 50 (69) vs ≥ 50 (135)	7 vs 7	0.97
Postoperative
Immunosuppressive regimen	FK (166) vs CsA (38)	32 vs 2	< 0.0001
Proceeding CMV infection	Yes (82) vs No (116)	7 vs 8	0.91
Early acute rejection	Yes (61) vs No (143)	11 vs 6	0.14

LAR: Late onset acute rejection; MELD: Model for end stage liver disease; HLA-n: Human leukocyte antigen n allele; LCX: Lymphocytotoxic crossmatch; SLV: Standard liver volume; CMV: Cytomegalovirus.

Table 3 Actual trough levels of calcineurin inhibitors six months after transplantation

Group	All	LAR	No LAR	P
	Mean (range)	Mean (range)	Mean (range)
Tacrolimus (μg/L)	7.0 (4.5-11.3)	7.4 (6.5-9.2)	7.0 (4.5-11.3)	0.47
Cyclosporine (μg/L)	133 (70-210)	135 (79-210)	128 (70-190)	0.35

LAR: Late onset acute rejection.