ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2020
Frailty Is Associated With Increased Rates of Acute Cellular Rejection Within 3 Months After Liver Transplantation.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- AASLD AST Practice Guideline on adult liver transplantation: Candidate evaluation.Hepatology (Baltimore, Md.) · 2026Guideline
- Frailty in hepatobiliary and pancreatic (HBP) surgery: a narrative review toward an HBP-specific, implementation-oriented framework.Gland surgery · 2026Review
- The perioperative management of geriatric patients in transplantation surgery-clinical, immunological, and translational considerations.Frontiers in transplantation · 2025Review
- Immunosuppression in adult liver transplant recipients: a 2024 update from the Italian Liver Transplant Working Group.Hepatology international · 2024Review
- Frailty in liver transplantation: Exploring prescribing exercise as medicine to improve patient outcomes.Liver international : official journal of the International Association for the Study of the Liver · 2024Review
- Detrimental impact of early biopsy-proven rejection in liver transplantation.Clinical transplantation · 2024Article
- Pretransplant Functional Status Predicts Postoperative Morbidity and Mortality after Liver Transplantation in Patients with Cirrhosis.Gut and liver · 2023Article
- Cellular Senescence and Frailty in Transplantation.Current transplantation reports · 2023Article
- Osteosarcopenia in NAFLD/MAFLD: An Underappreciated Clinical Problem in Chronic Liver Disease.International journal of molecular sciences · 2023Review
- Effects of an active lifestyle on the physical frailty of liver transplant candidates.World journal of transplantation · 2022Article
- Improving the prognosis before and after liver transplantation: Is muscle a game changer?World journal of gastroenterology · 2022Review
- Reduced upper limb lean mass on dual energy X-ray absorptiometry predicts adverse outcomes in male liver transplant recipients.World journal of transplantation · 2022Article
- Evaluating the Associations Between the Liver Frailty Index and Karnofsky Performance Status With Waitlist Mortality.Transplantation direct · 2021Article
- Karnofsky performance status predicts outcomes in candidates for simultaneous liver-kidney transplant.Clinical transplantation · 2021Article
- CONUT Score Predicts Early Morbidity After Liver Transplantation: A Collaborative Study.Frontiers in nutrition · 2021Article
- Impact of Sarcopenia on Simultaneous Pancreas and Kidney Transplantation Outcomes: A Retrospective Observational Cohort Study.Transplantation direct · 2020Article
- Frailty as an Immune-Mediated Condition That Leads to an Increased Risk of Acute Cellular Rejection in Liver Transplant Recipients.Clinical liver disease · 2020Review
- Frailty Is Associated With Increased Rates of Acute Cellular Rejection Within 3 Months After Liver Transplantation.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2020Article
- [Exocrine Pancreatic Insufficiency in Hepatic Cirrhosis: a Cross-Sectional Study].Acta gastroenterologica LatinoamericanaArticle
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6 authors at 1 institution in 1 country.
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Abstract
Frailty, a state of decreased physiological reserve, has been associated with dysregulation of the immune system. We hypothesized that frailty is associated with differential rates of acute cellular rejection (ACR) in liver transplantation (LT) recipients. Our study included LT recipients from 2014 to 2016 who had a pre-LT frailty assessment using the liver frailty index (LFI). Frailty was defined as an LFI ≥4.5. ACR at 3 months was ascertained from pathology reports, and immunosuppression regimens were collected from chart review. There were 241 LT recipients who were included: 46 (19%) were classified as frail before LT. Median tacrolimus trough levels, mycophenolate doses, and corticosteroid doses at discharge and 3 months were similar between frail and nonfrail patients. Within 3 months after LT, 7 (15%) frail patients versus 10 (5%) nonfrail patients experienced ACR (P = 0.02). In the univariate analysis, frailty was associated with a higher odds of ACR at 3 months (OR, 3.3; 95% confidence interval, 1.2-9.3; P = 0.02). Bivariate analyses were conducted with covariates that were associated with ACR in the univariate analysis or that were previously associated with either frailty (age and female sex) or ACR (Model for End-Stage Liver Disease score and ascites), as well as relevant immunosuppression variables. In the bivariate analyses, frailty remained significantly associated with ACR at 3 months with an odds ratio relatively similar to the unadjusted value. In conclusion, frailty is associated with an increased rate of ACR within 3 months, despite similar immunosuppression regimens, suggesting that frailty should be considered in immediate post-LT management.
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