Objective To investigate the clinical features and treatment in patients with acute rejection (AR) caused by immunosuppressants self-withdrawal (IS) after liver transplantation(LT).
Methods Clinical data of 3 cases with AR due to IS after LT from January 2004 to June 2013 in Liver Transplantation Center of Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University were analyzed retrospectively.
Results Three patients were hospitalized for abnormal liver function after IS. The time of IS was 18-42 d. And acute cellular rejection was confirmed by liver biopsy histopathology. Immunosuppressants were reused and small dose of hormone was used after therapy of adrenocortical hormone shock or rabbit anti-human thymocyte immunoglobulin. Two patients recovered after treatment, and 1 patient died after invalid rescue.
Conclusions IS after liver transplantation is prone to AR, usually resulting in serious consequences. Publicity and education of patients should be strengthened to improve their compliance of taking medicine. Once AR occurs, immunosuppressive drugs should be reused immediately with hormone shock or antibody therapy simultaneously.
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