To explore a reasonable and effective treatment scheme of antibody-mediated rejection (AMR) after liver transplantation.

The clinical data of AMR recipients after adult liver transplantation and acute cellular rejection (ACR) recipients after adult liver transplantation from March 2015 to December 2018 in Tianjin First Central Hospital were retrospectively analyzed. The perioperative data, glucocorticoid dosage and maintenance time, intervention treatment and disease outcomes of the two groups were collected and compared the efficacy difference of conventional anti-rejection therapy on AMR and ACR after liver transplantation.

The onset time of AMR was later than that of ACR, and the diagnosis time of AMR group and ACR group was (413±97) d and (12±5) d after liver transplantation, respectively (t=30.430, P<0.05). The duration of glucocorticoid treatment in AMR group was (29±15) d, which was longer than that in ACR group [(11±6) d] (t=6.122, P<0.05). In the case of standard immunosuppressive regimens, the proportion of recipients requiring glucocorticoid shock therapy was higher in the AMR group than in the ACR group (8/8 vs. 21/50, P<0.05), and the proportion of recipients requiring combined intervention was higher in the AMR group than in the ACR group (3/8 vs. 0, P<0.05).

Compared with ACR, AMR is usually necessary to extend the course of glucocorticoid therapy, combined with gamma globulin, plasma exchange and other interventions.