Low-dose aspirin confers protection against acute cellular allograft rejection after primary liver transplantation. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Oberkofler, C. E., Raptis, D. A., Müller, P. C., Sousa da Silva, R. X., Lehmann, K., Ito, T., Owen, T., Pollok, J. M., Parente, A., Schlegel, A., Peralta, P., Winter, E., Selzner, M., Fodor, M., Maglione, M., Jaklitsch, M., Marques, H. P., Chavez-Villa, M., Contreras, A., Kron, P., Lodge, P., Alford, S., Rana, A., Magistri, P., Di Benedetto, F., Johnson, B., Kirchner, V., Bauldrick, F., Halazun, K. J., Ghamarnedjad, O., Mehrabi, A., Basto, S. T., Fernandes, E. S., Paladini, J., de Santibañes, M., Florman, S., Tabrizian, P., Dutkowski, P., Clavien, P. A., Busuttil, R. W., Kaldas, F. M., Petrowsky, H. 2022


To investigate the effect of low-dose aspirin in primary adult liver transplantation LT on acute cellular rejection ACR as well as arterial patency rates.The use of low-dose aspirin after LT is practiced by many transplant centers to minimize the risk of hepatic artery thrombosis HAT, although solid recommendations do not exist. However, aspirin also possesses potent anti-inflammatory properties and might mitigate inflammatory processes after LT, such as rejection. Therefore, we hypothesized that the use of aspirin after liver transplantation has a protective effect against ACR.This is an international, multicenter cohort study of primary adult deceased donor LT. The study included 17 high-volume LT centers and covered the 3-year period from 2013 to 2015 to allow a minimum 5-year follow-up.In this cohort of 2,365 patients, prophylactic antiplatelet therapy with low-dose aspirin was administered in 1,436 recipients 61%. One-year rejection-free survival rate was 89% in the aspirin group versus 82% in the no-aspirin group HR 0.77, 95% CI 0.63-0.94, p=0.01. One-year primary arterial patency rates were 99% in the aspirin and 96% in the no-aspirin group with a HR of 0.23 95% CI: 0.13-0.40; p<0.001.Low-dose aspirin was associated with a lower risk of ACR and HAT after LT, especially in the first vulnerable year after transplantation. Therefore, low-dose aspirin use after primary LT should be evaluated to protect the liver graft from ACR and to maintain arterial patency.

View details for DOI 10.1002/lt.26534

View details for PubMedID 35735232