dc.contributor.author
Eurich, Dennis
dc.contributor.author
Schlickeiser, Stephan
dc.contributor.author
Ossami Saidy, Ramin Raul
dc.contributor.author
Uluk, Deniz
dc.contributor.author
Rossner, Florian
dc.contributor.author
Postel, Maximilian
dc.contributor.author
Schoening, Wenzel
dc.contributor.author
Oellinger, Robert
dc.contributor.author
Lurje, Georg
dc.contributor.author
Pratschke, Johann
dc.contributor.author
Reinke, Petra
dc.contributor.author
Gruen, Natalie
dc.date.accessioned
2024-06-28T12:33:20Z
dc.date.available
2024-06-28T12:33:20Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/44004
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-43713
dc.description.abstract
Background: Operational tolerance as the ability to accept the liver transplant without pharmacological immunosuppression is a common phenomenon in the long-term course. However, it is currently underutilized due to a lack of simple diagnostic support and fear of rejection despite its recognized benefits. In the present work, we present a simple score based on clinical parameters to estimate the probability of tolerance. Patients and methods: In order to estimate the probability of tolerance, clinical parameters from 82 patients after LT who underwent weaning from the IS for various reasons at our transplant center were extracted from a prospectively organized database and analyzed retrospectively. Univariate testing as well as multivariable logistic regression analysis were performed to assess the association of clinical variables with tolerance in the real-world setting. Results: The most important factors associated with tolerance after multivariable logistic regression were IS monotherapy, male sex, history of hepatocellular carcinoma pretransplant, time since LT, and lack of rejection. These five predictors were retained in an approximate model that could be presented as a simple scoring system to estimate the clinical probability of tolerance or IS dispensability with good predictive performance (AUC = 0.89). Conclusion: In parallel with the existence of a tremendous need for further research on tolerance mechanisms, the presented score, after validation in a larger collective preferably in a multicenter setting, could be easily and safely applied in the real world and already now address all three levels of prevention in LT patients over the long-term course.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
liver transplantation
en
dc.subject
operational tolerance
en
dc.subject
immunosuppression
en
dc.subject
graft rejection
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
How to Estimate the Probability of Tolerance Long-Term in Liver Transplant Recipients
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
6546
dcterms.bibliographicCitation.doi
10.3390/jcm12206546
dcterms.bibliographicCitation.journaltitle
Journal of Clinical Medicine
dcterms.bibliographicCitation.number
20
dcterms.bibliographicCitation.originalpublishername
MDPI AG
dcterms.bibliographicCitation.volume
12
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
37892685
dcterms.isPartOf.eissn
2077-0383