Observational studyClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2017
Acute Rejection Increases Risk of Graft Failure and Death in Recent Liver Transplant Recipients.
Observational study in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01619475 (A2ALL), which is not on this map. Cited by 114 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A2ALL: Adult-to-Adult Living Transplant Cohort Study
Who cites it
114 citing papers in PubMed, 2 syntheses or guidelines pooled it, 230 citations in OpenAlex.
- Navigating the risks: a systematic review of immune checkpoint inhibitor therapy before liver transplant for hepatocellular carcinoma and its impact on allograft rejection and survival outcomes.Frontiers in oncology · 2025Pooled it
- Meta-analysis and meta-regression of outcomes for adult living donor liver transplantation versus deceased donor liver transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Pooled it
- Donor-derived regulatory dendritic cell infusion and early immunosuppressive drug withdrawal in living-donor liver transplantation: a phase I/IIa trial.Nature communications · 2026Trial
- Tacrolimus dosing in liver transplant recipients using phenotypic personalized medicine: A phase 2 randomized clinical trial.Nature communications · 2025Trial
- Safety and Efficacy of Budesonide for Liver Transplant Immune Suppression: Results of a Pilot Phase 2a Trial.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2020Trial
- Applicability of common inflammatory markers in diagnosing infections in early period after liver transplantation in intensive care setting.Scientific reports · 2020Trial
- Review
- Risk Factors for Acute Rejection in Pediatric Lung Transplantation and Its Impact on Graft Failure.Pediatric pulmonology · 2026Article
- Systemic Treatment for Hepatocellular Carcinoma Recurrence After Liver Transplantation.Current oncology (Toronto, Ont.) · 2026Review
- Screening and care of patients with graft cirrhosis following liver transplantation.Canadian liver journal · 2026Article
- Advancing precision tacrolimus therapy: a systems genetics dissection in BXD platform.Frontiers in immunology · 2026Article
- Donor-derived cell-free DNA as a noninvasive biomarker for diagnosis and monitoring of acute rejection after liver transplantation.Frontiers in immunology · 2026Article
- Third annual transplant AI symposium: from organ matching to digital twins.Frontiers in transplantation · 2026Article
- Machine learning driven precision medicine in tacrolimus dosing: current research and future perspectives in liver and kidney transplantation.Frontiers in immunology · 2026Review
- Postoperative Outcomes and Risk Profiles in Dual Liver-Lung Transplantation: A Single-Center Retrospective Analysis.Journal of transplantation · 2026Article
- Plasma microRNAs and chemokines as biomarkers for rejection in liver transplantation with score verification and tissue correlation.Scientific reports · 2025Article
- Single-cell transcriptional landscape of liver transplant rejection reveals tissue persistence of clonally expanded, treatment-resistant T cells.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Impact of SIRPα genotype combinations in recipients and donors on alloimmune response in liver transplantation.PNAS nexus · 2025Article
- Immunological Rejection in a Heterotopic Rat Liver Transplant Model.Transplantation proceedings · 2025Article
- Immune checkpoint inhibitors use in liver transplantation for hepatocellular carcinoma: a global cohort study.BMC medicine · 2025Article
54 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsAcute rejection is detrimental to most transplanted solid organs, but is considered to be less of a consequence for transplanted livers. We evaluated risk factors for and outcomes after biopsy-proven acute rejection (BPAR) based on an analysis of a more recent national sample of recipients of liver transplants from living and deceased donors.
methodsWe analyzed data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) from 2003 through 2014 as the exploratory cohort and the Scientific Registry of Transplant Recipients (SRTR) from 2005 through 2013 as the validation cohort. We examined factors associated with time to first BPAR using multivariable Cox regression or discrete-survival analysis. Competing risks methods were used to compare causes of death and graft failure between recipients of living and deceased donors.
resultsAt least 1 BPAR episode occurred in 239 of 890 recipients in A2ALL (26.9%) and 7066 of 45,423 recipients in SRTR (15.6%). In each database, risk of rejection was significantly lower when livers came from biologically related living donors (A2ALL hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.43-0.76; and SRTR HR, 0.78; 95% CI, 0.66-0.91) and higher in liver transplant recipients with primary biliary cirrhosis, of younger age, or with hepatitis C. In each database, BPAR was associated with significantly higher risks of graft failure and death. The risks were highest in the 12 month post-BPAR period in patients whose first episode occurred more than 1 year after liver transplantation: HRs for graft failure were 6.79 in A2ALL (95% CI, 2.64-17.45) and 4.41 in SRTR (95% CI, 3.71-5.23); HRs for death were 8.81 in A2ALL (95% CI, 3.37-23.04) and 3.94 in SRTR (95% CI, 3.22-4.83). In analyses of cause-specific mortality, associations were observed for liver-related (graft failure) causes of death but not for other causes.
conclusionsContrary to previous data, acute rejection after liver transplant is associated with significantly increased risk of graft failure, all-cause mortality, and graft failure-related death, regardless of primary liver disease etiology. Living donor liver transplantation from a biologically related donor is associated with decreased risk of rejection.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.