Is blood eosinophilia an effective predictor of acute rejection in living donor liver transplantation?
Is blood eosinophilia an effective predictor of acute rejection in living donor liver transplantation?
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DOI：
10.1111/j.1432-2277.2005.00189.x
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发表时间：
2005-10-01
影响因子：
3.1
通讯作者：
Makuuchi, M
中科院分区：
文献类型：
--
作者：
Kishi, Y;Sugawara, Y;Makuuchi, M
血嗜酸性粒细胞增多症与活体肝移植后急性细胞排斥反应（ACR）的关系尚未研究。受试者为167例接受肝活检（314次）的受者。按ACR严重程度分层，比较术前（n = 167）、活检前3天（n = 314）和活检当天（n = 314）的血嗜酸性粒细胞计数。在314例活检标本中，140例活检标本被诊断为ACR。在140例ACR发作中，比较了治疗前和治疗后对治疗有反应（n = 80）和无反应（n = 60）的发作之间的嗜酸性粒细胞计数。术前嗜酸性粒细胞计数> 130 mm3预测ACR的敏感性和特异性分别为33%和65%。活检前3天和当天嗜酸性粒细胞计数> 400 mm3与ACR的严重程度相关（P < 0.0001）。预测ACR的敏感性分别为26%和33%，特异性分别为94%和93%。有反应者与无反应者之间的嗜酸性粒细胞计数变化无显著差异。目前的结果表明，嗜酸性粒细胞增多症作为活体肝移植后ACR的预测因子的作用有限。
The association of blood eosinophilia with acute cellular rejection (ACR) after living donor liver transplantation has not been examined yet. The subjects were the 167 recipients who underwent liver biopsy (314 times). The blood eosinophil counts in the preoperative period (n = 167), 3 days before (n = 314) and on the day of biopsy (n = 314) were compared among the groups stratified by severity of ACR. Among 314 biopsy specimens, the 140 biopsy specimens were diagnosed with ACR. In the 140 ACR episodes, eosinophil counts before and after therapy was compared between the episodes that responded to therapy (n = 80) and those not (n = 60). The sensitivity and specificity of preoperative eosinophilia (eosinophil counts > 130 mm(3)) to predict ACR was 33% and 65%, respectively. The eosinophil counts > 400 mm(3) 3 days before and on the day of biopsy was associated with the severity of ACR (P < 0.0001). The sensitivity to predict ACR was 26% and 33%, and the specificity, 94% and 93%, respectively. There was no significant difference in changes of eosinophil counts between the steroid-responders versus the nonresponders. The present results suggested the limited role of eosinophilia as a predictor of ACR after living donor liver transplantation.