Manifestations of Liver Transplant Rejection by Category
Rejection Category | Description |
|---|---|
Hyperacute rejection | Aggressive antibody-mediated injury immediately after ABO incompatible liver transplantation (very rare) |
Acute TCMR | Most frequent form. Usually within 3 months after transplantation. Late rejection can happen with the nonadherance to immune suppressants. Incidence up to 64% |
Acute AMR | Related to DSA which are either preformed or developed de novo after transplantation. Incidence less than 1% |
Chronic rejection | Usually from repeated undertreated TCMRs or a severe AMR Incidence 5% in adult recipients and 16% in pediatric recipients |
AMR = antibody-mediated rejection; DSA = donor-specific antibodies; TCMR = T-cell mediated rejection. Montano-Loza AJ, Rodríguez-Perálvarez ML, Pageaux GP, et al. Liver transplantation immunology: Immunosuppression, rejection, and immunomodulation. J Hepatol. 2023;78(6):1199-1215. doi:10.1016/j.jhep.2023.01.030 | |