1. Low-dose aspirin confers protection against acute cellular allograft rejection after primary liver transplantation
- Author
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Oberkofler, Christian E, Raptis, Dimitri A, Müller, Philip C, Sousa da Silva, Richard X, Lehmann, Kuno, Ito, Takahiro, Owen, Timothy, Pollok, Joerg-Matthias, Parente, Alessandro, Schlegel, Andrea, Peralta, Peregrina, Winter, Erin, Selzner, Markus, Fodor, Margot, Maglione, Manuel, Jaklitsch, Manuel, Marques, Hugo P, Chavez-Villa, Mariana, Contreras, Alan, Kron, Philipp, Lodge, Peter, Alford, Scott, Rana, Abbas, Magistri, Paolo, Di Benedetto, Fabrizio, Johnson, Bethany, Kirchner, Varvara, Bauldrick, Francis, Halazun, Karim J, Ghamarnedjad, Omid, Mehrabi, Arianeb, Basto, Samanta Teixeira, Fernandes, Eduardo SM, Paladini, Jose, de Santibañes, Martin, Florman, Sander, Tabrizian, Parissa, Dutkowski, Philipp, Clavien, Pierre-Alain, Busuttil, Ronald W, Kaldas, Fady M, and Petrowsky, Henrik
- Subjects
Graft Rejection ,Adult ,Transplantation ,Prevention ,Liver Disease ,Graft Survival ,Clinical Sciences ,Thrombosis ,Organ Transplantation ,Allografts ,Liver Transplantation ,Cohort Studies ,Risk Factors ,Clinical Research ,Humans ,Surgery ,Digestive Diseases ,Retrospective Studies - Abstract
This study investigated the effect of low-dose aspirin in primary adult liver transplantation (LT) on acute cellular rejection (ACR) as well as arterial patency rates. The use of low-dose aspirin after LT is practiced by many transplant centers to minimize the risk of hepatic artery thrombosis (HAT), although solid recommendations do not exist. However, aspirin also possesses potent anti-inflammatory properties and might mitigate inflammatory processes after LT, such as rejection. Therefore, we hypothesized that the use of aspirin after LT has a protective effect against ACR. This is an international, multicenter cohort study of primary adult deceased donor LT. The study included 17 high-volume LT centers and covered the 3-year period from 2013 to 2015 to allow a minimum 5-year follow-up. In this cohort of 2365 patients, prophylactic antiplatelet therapy with low-dose aspirin was administered in 1436 recipients (61%). The 1-year rejection-free survival rate was 89% in the aspirin group versus 82% in the no-aspirin group (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.63-0.94; p=0.01). The 1-year primary arterial patency rates were 99% in the aspirin group and 96% in the no-aspirin group with an HR of 0.23 (95% CI, 0.13-0.40; p
- Published
- 2022