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- Title
Vitamin D and the risk of acute allograft rejection following human liver transplantation.
- Authors
Bitetto, Davide; Fabris, Carlo; Falleti, Edmondo; Fornasiere, Ezio; Fumolo, Elisa; Fontanini, Elisabetta; Cussigh, Annarosa; Occhino, Giuseppa; Baccarani, Umberto; Pirisi, Mario; Toniutto, Pierluigi
- Abstract
Background: Vitamin D may act as an immune modulator in experimental and human organ transplantation, but these data are yet to be confirmed in human liver transplantation (LT). Aim: This study aimed to assess the relationship between acute liver allograft cellular rejection (ACR) and pretransplant serum vitamin D concentration or post-transplant vitamin D supplementation. Method: We studied 133 LT recipients who underwent two per protocol allograft biopsies in the early post-operative period, plus on-demand biopsies as clinically indicated. ACR estimate was given according to the Banff scheme in biopsies obtained along two follow-up periods: (a) from the transplant operation to the end of the second month (0–2 months); (b) and from the third month to the end of the eighth month (3–8 months) post-LT. Results: The median pretransplant serum 25-hydroxyvitamin D concentration was 12.5 ng/ml; 40 patients had concentrations ≤12.5 ng/ml, of whom six had ≤5.0 ng/ml. Seventy-nine recipients received oral vitamin D3 supplementation to treat post-transplant osteoporosis. In the 0–2 months period, moderate-to-severe rejection episodes were independently associated with cytomegalovirus reactivation ( P<0.005) and progressively lower pretransplant serum 25-hydroxyvitamin D concentrations ( P<0.02). Early vitamin D3 supplementation was independently associated with a lack of ACR ( P<0.05). Conclusions: These results suggest that vitamin D may favour immune tolerance towards the liver allograft.
- Subjects
GRAFT rejection; VITAMIN D; LIVER transplantation; TRANSPLANTATION immunology; SERUM
- Publication
Liver International, 2010, Vol 30, Issue 3, p417
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/j.1478-3231.2009.02154.x