Announcements

Seminar In Medicine, 15.01.2019, Prof. Dr. Murat Akyıldız

Author: KUSOM
Time: 14:00
Location: MED 176

KOÇ UNIVERSITY

SCHOOL OF MEDICINE

 
SEMINAR IN MEDICINE
Tuesday, January 15th,
 2019

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Speaker         : Prof. Dr. Murat Akyıldız, Koç University Hospital, Department of 
Gastroenterology

Title               : Non-Invasive Markers of Acute&Chronic Rejection in Liver Transplantation

Time              : 14.00 (Refreshments will be served at 13:45)

Place              : MED 176

TelePresence   : AH 5th floor Chief Medical Officer / KUH 9th floor Meeting Room

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NON-INVASIVE MARKERS OF ACUTE&CHRONIC REJECTİON IN LIVER TRANSPLANTATION

Liver transplantation (LT) is the only curative treatment of decompensated liver diseases and hepatocellular carcinoma.The diagnosis of rejection, the impairment of graft functions, is made after excluding toxic, infectious, biliary and/or vascular technical problem. Physicians should be aware of the risk of acute, late onset and chronic rejection episodes after LT.

Acute allograft rejection remains a common complication of LT, with the incidence ranging between 20% to 40% whereas rejection usually occurs within the first month following LT.Furthermore, early rejection episodes do not significantly impair long-term graft success or patient outcomes. In contrast, late-onset allograft rejection (>3–6 monthsfollowing LT) is associated with poor graft survival. Several risk factors for acute allograft rejection have been described, including younger recipient age, HLA-DR mismatch, longer cold ischemic time, and older donor age. There are increasing number of studies regarding the non-invasive markers in post-LT setting. Clinical follow-up and biochemical markers are the most common methods that are used in daily practice for rejection. Studies about cytokines and inflammation markers are promising such as CXCL-9/10, IL17, CD44. Eosinophilia and increased bilirubin levels with cholestatic pattern of liver chemistry may be employed to detect ACR whereas hepatic artery resistive index-(RI) and liver stifness measurements may help in clinical practice. Most of the liver transplant centers do not check donor spesific antibody (DSA) due to not being cost effective. However, routine DSA should be checked for antibody mediated rejection(AMR) and CR. Despite all these markers, the gold standard diagnostic method is still liver biopsy for rejection.