Protocol liver biopsy is the only examination that can detect mid-term graft fibrosis after pediatric liver transplantation

Table 5 Risk factors for ≥ A1 and ≥ F1 of protocol liver biopsy at five years after living donor liver transplantation: univariable analysis

Variables	Incidence of≥A1 (%)	P-value	Incidence of≥F1 (%)	P-value
Recipient age at LDLT
< 12 mo (n = 18) vs≥ 12 mo (n = 37)	38.9 vs 51.4	0.385	38.9 vs 32.4	0.637
Recipient body weight at LDLT
< 10 kg (n = 29) vs≥ 10 kg (n = 26)	41.4 vs 53.8	0.355	55.0 vs 30.8	0.577
Original disease
Cholestatic diseases (n = 45) vs others (n = 10)	46.7 vs 50.0	0.850	35.6 vs 33.3	0.738
PELD or MELD
≥ 20 (n = 12) vs < 20 (n = 43)	41.7 vs 48.8	0.660	41.7 vs 52.6	0.558
Donor age
≥ 35 yr (n = 22) vs < 35 yr (n = 33)	40.9 vs 51.5	0.440	36.4 vs 33.3	0.816
Gender combinations between donor and recipient
Mismatch (n = 30) vs match (n = 25)	53.3 vs 40.0	0.324	40.0 vs 28.0	0.352
ABO compatibility
incompatible (n = 7) vs others (n = 48)	42.9 vs 47.9	0.802	28.6 vs 35.4	0.722
HLA-A
Mismatch (n = 41) vs match (n = 14)	51.2 vs 35.7	0.316	39.0 vs 21.4	0.232
HLA-B
Mismatch (n = 52) vs match (n = 3)	48.1 vs 33.3	0.619	32.7 vs 66.7	0.229
HLA-DRB1
Mismatch (n = 47) vs match (n = 8)	51.1 vs 25.0	0.172	36.2 vs 25.0	0.539
Lymphocyte cross-matching
≥ 4 × (n = 16) vs negative (n = 39)	31.3 vs 53.8	0.127	18.8 vs 41.0	0.115
GV/SLV
< 40 % (n = 2) vs≥ 40 % (n = 53)	0.0 vs 49.1	0.173	0.0 vs 35.8	0.295
Graft type
Lateral segment graft (n = 43) vs others (n = 12)	51.2 vs 33.3	0.274	39.5 vs 16.7	0.141
Operation time
≥ 20 h (n = 16) vs < 20 h (n = 39)	37.5 vs 51.3	0.352	31.3 vs 35.9	0.742
Cold ischemic time
≥ 2 h (n = 40) vs < 2 h (n = 15)	55.0 vs 26.7	0.061	40.0 vs 20.0	0.165
Warm ischemic time
≥ 1 h (n = 42) vs < 1 h (n = 13)	42.9 vs 61.5	0.238	31.0 vs 46.2	0.314
Blood loss volume
≥ 150 mL/kg (n = 11) vs < 150 mL/kg (n = 44)	27.3 vs 52.3	0.137	27.3 vs 36.4	0.57
Transfusion volume
≥ 100 mL/kg (n = 15) vs < 100 mL/kg (n = 40)	40.0 vs 50.0	0.508	40.0 vs 32.5	0.603
Splenectomy
Yes (n = 2) vs No (n = 53)	100.0 vs 45.3	0.128	0.0 vs 35.8	0.295
Portal vein complications
Yes (n = 9) vs No (n = 46)	44.4 vs 47.8	0.852	33.3 vs 34.8	0.933
Hepatic arterial complications
Yes (n = 4) vs No (n = 51)	25.0 vs 49.0	0.354	25.0 vs 35.3	0.677
Hepaticojejunostomic anastomotic stricture
Yes (n = 16) vs No (n = 39)	31.3 vs 53.8	0.127	25.0 vs 38.5	0.340
Cytomegalovirus infection
Yes (n = 17) vs No (n = 38)	47.1 vs 47.4	0.999	47.1 vs 28.9	0.192
Acute cellular rejection
Yes (n = 23) vs No (n = 32)	60.9 vs 37.5	0.087	47.8 vs 25.0	0.079
Total bilirubin at PLB
≥ 0.7 mg/dL (n = 25) vs < 0.7 mg/dL (n = 30)	48.0 vs 46.7	0.920	36.0 vs 33.3	0.836
AST at PLB
≥ 30 IU/L (n = 22) vs < 30 IU/L (n = 33)	54.5 vs 42.4	0.378	36.4 vs 33.3	0.816
ALT at PLB
≥ 20 IU/L (n = 21) vs < 20 IU/L (n = 34)	57.1 vs 41.2	0.249	28.6 vs 38.2	0.464
γ-GTP at PLB
≥ 20 IU/L (n = 20) vs < 20 IU/L (n = 35)	45.0 vs 48.6	0.799	30.0 vs 37.1	0.592
Hyaluronic acid at PLB
≥ 20 ng/mL (n = 22) vs < 20 ng/mL (n = 33)	50.0 vs 45.5	0.741	36.4 vs 33.3	0.816
IgG at PLB
≥ 1200 mg/dL (n = 24) vs < 1200 mg/dL (n = 31)	54.2 vs 41.9	0.368	41.7 vs 29.0	0.328
ANA at PLB
≥ 20 × (n = 14) vs < 20 × (n = 41)	35.7 vs 51.2	0.316	28.6 vs 36.6	0.586
ASMA at PLB
≥ 20 × (n = 10) vs < 20 × (n = 45)	70.0 vs 42.2	0.111	40.0 vs 33.3	0.688
Trough of tacrolimus at PLB
≥ 3.0 ng/mL (n = 19) vs < 3.0 ng/mL (n = 33)1	52.6 vs 42.4	0.477	36.8 vs 33.3	0.797

¹Three cases which were used a cyclosporine were removed. LDLT: Living donor liver transplantation; PELD: Pediatric end-stage liver disease; MELD: Model for end-stage liver disease; GV/SLV: Ratio of graft volume to standard liver volume; PLB: Protocol liver biopsy; AST: Aspartate amino transferase; ALT: Alanine amino transferase; IgG: Immunoglobulin G; ANA: Antinuclear antibody; ASMA: Antismooth nuclear antibody.