YÜKSELMİŞ KAN EOZİNOFİL SAYISI CANLI VERİCİLİ KARACİĞER TRANSPLANTASYONU SONRASI GEÇ ORTAYA ÇIKAN AKUT REJEKSİYONUN (GOAR) TAHMİNİNDE ÖNEMLİ BİR BELİRTEÇ OLABİLİR Mİ?

Mücahit Özbilgin; Tufan Egeli; Tarkan Ünek; Cihan Ağalar; Alikadir Değirmenci; Sevda Özkardesler; Özgül Sağol; Hülya Ellidokuz; İbrahim Astarcıoğlu

doi:10.17343/sdutfd.429435

Research Article

YÜKSELMİŞ KAN EOZİNOFİL SAYISI CANLI VERİCİLİ KARACİĞER TRANSPLANTASYONU SONRASI GEÇ ORTAYA ÇIKAN AKUT REJEKSİYONUN (GOAR) TAHMİNİNDE ÖNEMLİ BİR BELİRTEÇ OLABİLİR Mİ?

Year 2018, Volume: 25 Issue: 3, 303 - 310, 01.09.2018

Mücahit Özbilgin Tufan Egeli Tarkan Ünek Cihan Ağalar Alikadir Değirmenci Sevda Özkardesler Özgül Sağol Hülya Ellidokuz İbrahim Astarcıoğlu

https://doi.org/10.17343/sdutfd.429435

Abstract

Amaç: ‘’Geç dönemde
ortaya çıkan akut rejeksiyon”(GOAR); canlı vericili karaciğer
nakillerinde(CVKN) 6.aydan sonraki rejeksiyonlardır. Tanısında; karaciğer
biyopsisi yerine daha az noninvaziv bir yöntem olan artmış kan Eozinofil sayısı
prediktif bir biomarker olarak kullanılabilir mi?

Yöntem ve
Metod :
Araştırmamızda Dokuz Eylül Üniversitesi Tıp Fakültesi Genel Cerrahi Karaciğer
Nakli Biriminde Haziran 2000- 2017 yıllarında CVKN yapılan, 18 yaşından büyük
ve en az 6 ay sağkalımı olan hastalar çalışmaya dahil edilmiştir. GOAR gelişen
hastaların; demografik verileri, olması gereken greft ağırlığı/mevcut greft
ağırlığı oranı, soğuk iskemi süreleri, Child ve MELD skorları, immünossüpresif
rejimleri ve komorbiditeleri incelendi. GOAR’dan şüphelenilen olguların biyopsi
sonuçları ve biyopsi öncesi kan laboratuvar değerleri retrospektif olarak
tarandı.

Bulgular: Çalışmada 240
Karaciğer naklinden 65(%27)’ine rejeksiyondan şüphelenilerek karaciğer biyopsisi
yapıldı. Olguların 28(%43)’inde GOAR
tespit edilirken, 37(%57)’sinde herhangi bir rejeksiyon bulgusuna rastlanmadı.
Biyopsiler Banff patoloji skorlamasına göre; 10(%35.7)’u hafif,13(%46.4)’ü orta
ve 5(%17.9)’i şiddetli rejeksiyonlardı. Ortalama izlem süresi 3056(184-4877)
gündü. Biyopsi yapılma zamanı ortalama postoperatif 660’ıncı(180-4354) gündü.
Yükselmiş kan Eozinofil değeri ile GOAR gelişimi arasında istatistiksel olarak
anlamlı bir ilişki saptandı (p<0.001).

Sonuç: GOAR’un tanısında; karaciğer biyopsisine göre non-invaziv bir yöntem olan
yükselmiş kan Eozinofil değerleri prediktif bir belirteç olarak kullanılabilir.

Keywords

Yükselmiş Serum Eozinofil değeri

References

1.Demetris AJ, Adeyi O, Bellamy CO, et al. Liver biopsy interpretation for causes of late liver allograft dysfunction. Hepatology 2006; 44: 489.
2.Hubscher SG. Transplantation pathology. Semin Diagn Pathol 2006; 23: 170.
3.Samuel D, Gugenheim J, Canon C, Saliba F, Bismuth H. Use of OKT3 for late acute rejection in liver transplantation. Trans- plant Proc 1990;22: 1767-1768.
4.Mor E, Solomon H, Gibbs JF, Holman MJ, Goldstein RM, Husberg BS, et al. Acute cellular rejection following liver trans- plantation: Clinical pathologic features and effect on outcome. Semin Liver Dis 1992;12:28-40.
5. Goldman M, Le Moine A, Braun M, Flamand V, Abramowicz D.A role for eosinophils in transplant rejection.Trends Immunol. 2001 May;22(5):247-51.
6. Foster PF, Sankary HN, Hart M, Ashmann M, Williams JW. Blood and graft eosinophilia as predictors of rejection in human liver transplantation. Send to Transplantation. 1989 Jan;47(1):72-4.
7. Sanada Y, Ushijima K, Mizuta K, Urahashi T, Ihara Y, Wakiya T, Okada N, Yamada N, Egami S, Hishikawa S, Otomo S, Sakamoto K, Yasuda Y, Kawarasaki H.Prediction of acute cellular rejection by peripheral blood eosinophilia in pediatric living donor liver transplantation.Transplant Proc. 2012 Jun;44(5):1341-5.
8. Wang GY, Li H, Liu W, Zhang J, Zhu HB, Wang GS, Zhang Q, Yang Y, Chen GH. Elevated blood eosinophil count is a valuable biomarker for predicting late acute cellular rejection after liver transplantation.Transplant Proc. 2013 Apr;45(3):1198-200.
9.Demetris AJ, Batts KP, Dhillon AP, et al. Banff schema for grading liver allograft rejection: an international consensus document. Hepatology. 1997 Mar;25(3):658-63.
10. Mor E, Gonwa TA, Husberg BS, Goldstein RM, Klintmalm GB, Late-onset acute rejection in orthotopic liver transplantation-associated risk factors and outcome Transplantation1992;54:821-824
11. S. Florman, T. Schiano, L. Kim, et al.The incidence and significance of late acute cellular rejection (>1000 days) after liver transplantation Clin Transplant, 18 (2004), pp. 152-155
12.Demetris AJ, Ruppert K, Dvorchik I, et al. Real-time monitoring of acute liver-allograft rejection using the Banff schema. Transplantation 2002; 74: 1290.
13. Dousset B, Conti F, Cherruau B, et al. Is acute rejection deleterious to long-term liver allograft function? J Hepatol 1998; 29: 660.
14. Ramji A, Yoshida EM, Bain VG, Kneteman NM, Scudamore CH, Ma MM, Steinbrecher UP, Gutfreund KS, Erb SR, Partovi N, Chung SW, Shapiro J, Wong WW. Late acute rejection after liver transplantation: the Western Canada experience. Liver Transpl. 2002 Oct;8(10):945-51.
15. O'Grady JG, Burroughs A, Hardy P, Elbourne D, Truesdale A; UK and Republic of Ireland Liver Transplant Study Group. Tacrolimus versus microemulsified ciclosporin in liver transplantation: the TMC randomised controlled trial.Lancet. 2002 Oct 12;360(9340):1119-25.
16. Milkiewicz P, Gunson B, Saksena S, Hathaway M, Hubscher SG, Elias E. Increased incidence of chronic rejection in adult patients transplanted for autoimmune hepatitis: assessment of risk factors. Transplantation. 2000 Aug 15;70(3):477-80.
17. Hughes VF, Trull AK, Joshi O, Alexander GJ. Monitoring eosinophil activation and liver function after liver transplantation.Transplantation. 1998 May 27;65(10):1334-9.
18. de Groen PC, Kephart GM, Gleich GJ, Ludwig J. The eosinophil as an effector cell of the immune response during hepatic allograft rejection. Hepatology. 1994 Sep;20(3):654-62.
19. Dollinger MM, Plevris JN, Bouchier IA, Harrison DJ, Hayes PC. Peripheral eosinophil count both before and after liver transplantation predicts acute cellular rejection. Liver Transpl Surg. 1997 Mar;3(2):112-7.
20. Barnes EJ, Abdel-Rehim MM, Goulis Y, Abou Ragab M, Davies S, Dhillon A, Davidson B, Rolles K, Burroughs A. Applications and limitations of blood eosinophilia for the diagnosis of acute cellular rejection in liver transplantation. Am J Transplant. 2003 Apr;3(4):432-8.
21. Nagral A, Quaglia A, Sabin CA, Dhillon AP, Bearcroft CP, Millar A, Davies SE, Mistry PK, Davidson BR, Rolles K, Burroughs AK. Blood and graft eosinophils in acute cellular rejection of liver allografts.Transplant Proc. 2001 Jun;33(4):2588-93.
22. Romero R, Abramowsky CR, Pillen T, Smallwood GA, Heffron TG Peripheral eosinophilia and eosinophilic gastroenteritis after pediatric liver transplantation.Pediatr Transplant.2003Dec;7(6):484-8.
23. Rodríguez-Perálvarez M, Germani G, Tsochatzis E, Rolando N, Luong TV, Dhillon AP, Thorburn D, O'Beirne J, Patch D, Burroughs AK. Predicting severity and clinical course of acute rejection after liver transplantation using blood eosinophil count. Transpl Int. 2012 May;25(5):555-63.

Year 2018, Volume: 25 Issue: 3, 303 - 310, 01.09.2018

Mücahit Özbilgin Tufan Egeli Tarkan Ünek Cihan Ağalar Alikadir Değirmenci Sevda Özkardesler Özgül Sağol Hülya Ellidokuz İbrahim Astarcıoğlu

https://doi.org/10.17343/sdutfd.429435

Abstract

References

1.Demetris AJ, Adeyi O, Bellamy CO, et al. Liver biopsy interpretation for causes of late liver allograft dysfunction. Hepatology 2006; 44: 489.
2.Hubscher SG. Transplantation pathology. Semin Diagn Pathol 2006; 23: 170.
3.Samuel D, Gugenheim J, Canon C, Saliba F, Bismuth H. Use of OKT3 for late acute rejection in liver transplantation. Trans- plant Proc 1990;22: 1767-1768.
4.Mor E, Solomon H, Gibbs JF, Holman MJ, Goldstein RM, Husberg BS, et al. Acute cellular rejection following liver trans- plantation: Clinical pathologic features and effect on outcome. Semin Liver Dis 1992;12:28-40.
5. Goldman M, Le Moine A, Braun M, Flamand V, Abramowicz D.A role for eosinophils in transplant rejection.Trends Immunol. 2001 May;22(5):247-51.
6. Foster PF, Sankary HN, Hart M, Ashmann M, Williams JW. Blood and graft eosinophilia as predictors of rejection in human liver transplantation. Send to Transplantation. 1989 Jan;47(1):72-4.
7. Sanada Y, Ushijima K, Mizuta K, Urahashi T, Ihara Y, Wakiya T, Okada N, Yamada N, Egami S, Hishikawa S, Otomo S, Sakamoto K, Yasuda Y, Kawarasaki H.Prediction of acute cellular rejection by peripheral blood eosinophilia in pediatric living donor liver transplantation.Transplant Proc. 2012 Jun;44(5):1341-5.
8. Wang GY, Li H, Liu W, Zhang J, Zhu HB, Wang GS, Zhang Q, Yang Y, Chen GH. Elevated blood eosinophil count is a valuable biomarker for predicting late acute cellular rejection after liver transplantation.Transplant Proc. 2013 Apr;45(3):1198-200.
9.Demetris AJ, Batts KP, Dhillon AP, et al. Banff schema for grading liver allograft rejection: an international consensus document. Hepatology. 1997 Mar;25(3):658-63.
10. Mor E, Gonwa TA, Husberg BS, Goldstein RM, Klintmalm GB, Late-onset acute rejection in orthotopic liver transplantation-associated risk factors and outcome Transplantation1992;54:821-824
11. S. Florman, T. Schiano, L. Kim, et al.The incidence and significance of late acute cellular rejection (>1000 days) after liver transplantation Clin Transplant, 18 (2004), pp. 152-155
12.Demetris AJ, Ruppert K, Dvorchik I, et al. Real-time monitoring of acute liver-allograft rejection using the Banff schema. Transplantation 2002; 74: 1290.
13. Dousset B, Conti F, Cherruau B, et al. Is acute rejection deleterious to long-term liver allograft function? J Hepatol 1998; 29: 660.
14. Ramji A, Yoshida EM, Bain VG, Kneteman NM, Scudamore CH, Ma MM, Steinbrecher UP, Gutfreund KS, Erb SR, Partovi N, Chung SW, Shapiro J, Wong WW. Late acute rejection after liver transplantation: the Western Canada experience. Liver Transpl. 2002 Oct;8(10):945-51.
15. O'Grady JG, Burroughs A, Hardy P, Elbourne D, Truesdale A; UK and Republic of Ireland Liver Transplant Study Group. Tacrolimus versus microemulsified ciclosporin in liver transplantation: the TMC randomised controlled trial.Lancet. 2002 Oct 12;360(9340):1119-25.
16. Milkiewicz P, Gunson B, Saksena S, Hathaway M, Hubscher SG, Elias E. Increased incidence of chronic rejection in adult patients transplanted for autoimmune hepatitis: assessment of risk factors. Transplantation. 2000 Aug 15;70(3):477-80.
17. Hughes VF, Trull AK, Joshi O, Alexander GJ. Monitoring eosinophil activation and liver function after liver transplantation.Transplantation. 1998 May 27;65(10):1334-9.
18. de Groen PC, Kephart GM, Gleich GJ, Ludwig J. The eosinophil as an effector cell of the immune response during hepatic allograft rejection. Hepatology. 1994 Sep;20(3):654-62.
19. Dollinger MM, Plevris JN, Bouchier IA, Harrison DJ, Hayes PC. Peripheral eosinophil count both before and after liver transplantation predicts acute cellular rejection. Liver Transpl Surg. 1997 Mar;3(2):112-7.
20. Barnes EJ, Abdel-Rehim MM, Goulis Y, Abou Ragab M, Davies S, Dhillon A, Davidson B, Rolles K, Burroughs A. Applications and limitations of blood eosinophilia for the diagnosis of acute cellular rejection in liver transplantation. Am J Transplant. 2003 Apr;3(4):432-8.
21. Nagral A, Quaglia A, Sabin CA, Dhillon AP, Bearcroft CP, Millar A, Davies SE, Mistry PK, Davidson BR, Rolles K, Burroughs AK. Blood and graft eosinophils in acute cellular rejection of liver allografts.Transplant Proc. 2001 Jun;33(4):2588-93.
22. Romero R, Abramowsky CR, Pillen T, Smallwood GA, Heffron TG Peripheral eosinophilia and eosinophilic gastroenteritis after pediatric liver transplantation.Pediatr Transplant.2003Dec;7(6):484-8.
23. Rodríguez-Perálvarez M, Germani G, Tsochatzis E, Rolando N, Luong TV, Dhillon AP, Thorburn D, O'Beirne J, Patch D, Burroughs AK. Predicting severity and clinical course of acute rejection after liver transplantation using blood eosinophil count. Transpl Int. 2012 May;25(5):555-63.

There are 23 citations in total.

Details

Primary Language	Turkish
Subjects	Clinical Sciences
Journal Section	Research Articles
Authors	Mücahit Özbilgin Tufan Egeli This is me Tarkan Ünek This is me Cihan Ağalar This is me Alikadir Değirmenci This is me Sevda Özkardesler This is me Özgül Sağol Hülya Ellidokuz İbrahim Astarcıoğlu This is me
Publication Date	September 1, 2018
Submission Date	June 1, 2018
Acceptance Date	June 12, 2018
Published in Issue	Year 2018 Volume: 25 Issue: 3

Cite

Vancouver	Özbilgin M, Egeli T, Ünek T, Ağalar C, Değirmenci A, Özkardesler S, Sağol Ö, Ellidokuz H, Astarcıoğlu İ. YÜKSELMİŞ KAN EOZİNOFİL SAYISI CANLI VERİCİLİ KARACİĞER TRANSPLANTASYONU SONRASI GEÇ ORTAYA ÇIKAN AKUT REJEKSİYONUN (GOAR) TAHMİNİNDE ÖNEMLİ BİR BELİRTEÇ OLABİLİR Mİ?. Med J SDU. 2018;25(3):303-10.

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