Recipient gender and body mass index are associated with early acute rejection in donation after cardiac death liver transplantation

Background Early acute rejection (EAR) is a common complication after liver transplantation (LT). Aim The aim of this study was to evaluate the incidence and risk factors of EAR in donation after cardiac death (DCD) liver transplantation recipients. Method We retrospectively analysed the data of 461 DCD liver transplants performed during the period from January 2010 to June 2016 to study the relationship between EAR and various clinical factors. EAR was defined as histologically proven acute cellular rejection occurring less than 90 days after transplantation. Result The median follow-up time for this study was 33.1 months (range: 0.03–92.8 months). Thirty-two (6.9%) patients developed EAR with a median period of 20.5 days (5–88 days) after transplantation. A multivariate analysis revealed that female recipient (hazard ratio: 2.801; P=0.024) and high recipient body mass index (BMI) (hazard ratio: 1.005; P=0.049) were two independent risk factors for early acute rejection. Conclusions In DCD liver transplantation, recipient female gender and high BMI were associated with a higher incidence of EAR, while the use of CD25-Ab and/or MMF had a protective effect.