Graft-versus-host disease after liver transplantation: A comprehensive literature review

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dc.authoridYILMAZ, Mehmet/0000-0002-5710-5263
dc.authoridYilmaz, Sezai/0000-0002-8044-0297
dc.authoridAkbulut, Sami/0000-0002-6864-7711
dc.authorwosidYILMAZ, Mehmet/HKM-4739-2023
dc.authorwosidYilmaz, Sezai/ABI-2323-2020
dc.authorwosidYilmaz, Mehmet/AAF-6095-2021
dc.authorwosidAkbulut, Sami/L-9568-2014
dc.contributor.authorAkbulut, Sami
dc.contributor.authorYilmaz, Mehmet
dc.contributor.authorYilmaz, Sezai
dc.date.accessioned2024-08-04T20:36:10Z
dc.date.available2024-08-04T20:36:10Z
dc.date.issued2012
dc.departmentİnönü Üniversitesien_US
dc.description.abstractAIM: To determine the factors affecting mortality in patients who developed graft-versus-host disease (GvHD) after liver transplantation (LT). METHODS: We performed a review of studies of GvHD following LT published in the English literature and accessed the PubMed, Medline, EBSCO, EMBASE, and Google Scholar databases. Using relevant search phrases, 88 articles were identified. Of these, 61 articles containing most of the study parameters were considered eligible for the study. Risk factors were first examined using a univariate Kaplan-Meier model, and variables with a significant association (P < 0.05) were then subjected to multivariate analyses using a Cox proportional-hazards model. RESULTS: The 61 articles reported 87 patients, 58 male and 29 female, mean age, 40.4 +/- 15.5 years (range: 8 mo to 74 years), who met the inclusion criteria for the present study. Deaths occurred in 59 (67.8%) patients, whereas 28 (32.2%) survived after a mean follow-up period of 280.8 +/- 316.2 d (range: 27-2285 d). Among the most frequent symptoms were rash (94.2%), fever (66.6%), diarrhea (54%), and pancytopenia (54%). The average time period between LT and first symptom onset was 60.6 +/- 190.1 d (range: 2-1865 d). The Kaplan-Meier analysis revealed that pancytopenia (42.8% vs 59.3%, P = 0.03), diarrhea (39.2% vs 61.0%, P = 0.04), age difference between the recipient and the donor (14.6 +/- 3.1 years vs 22.6 +/- 2.7 years, P < 0.0001), and time from first symptom occurrence to diagnosis or treatment (13.3 +/- 2.6 mo vs 15.0 +/- 2.3 mo, P < 0.0001) were significant factors affecting mortality, whereas age, sex, presence of rash and fever, use of immunosuppressive agents, acute rejection before GvHD, etiological causes, time of onset, and donor type were not associated with mortality risk. The Cox proportional-hazards model, determined that an age difference between the recipient and donor was an independent risk factor (P = 0.03; hazard ratio, 7.395, 95% confidence interval, 1.2-46.7). CONCLUSION: This study showed that an age difference between the recipient and donor is an independent risk factor for mortality in patients who develop GvHD after LT. (C) 2012 Baishideng. All rights reserved.en_US
dc.identifier.doi10.3748/wjg.v18.i37.5240
dc.identifier.endpage5248en_US
dc.identifier.issn1007-9327
dc.identifier.issue37en_US
dc.identifier.pmid23066319en_US
dc.identifier.scopus2-s2.0-84867808122en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage5240en_US
dc.identifier.urihttps://doi.org/10.3748/wjg.v18.i37.5240
dc.identifier.urihttps://hdl.handle.net/11616/95824
dc.identifier.volume18en_US
dc.identifier.wosWOS:000309803600013en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherBaishideng Publ Grp Co Ltden_US
dc.relation.ispartofWorld Journal of Gastroenterologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectLiver transplantationen_US
dc.subjectGraft-versus-host diseaseen_US
dc.subjectImmunosuppressionen_US
dc.subjectRashen_US
dc.subjectPancytopeniaen_US
dc.subjectDiarrheaen_US
dc.subjectChimerismen_US
dc.subjectAge factorsen_US
dc.titleGraft-versus-host disease after liver transplantation: A comprehensive literature reviewen_US
dc.typeReview Articleen_US

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