The survival rates were 95.4%, 91.9%, 91.9%, 88.1% and 52.3% (1-, 3-, 5-, 7- and 10-year survival, respectively) in patients with abstinence, 83.3%, 83.3%, 83.3% and 83.3% (1-, 3-, 5- and 7-year survival) in patients with non-harmful relapse, and 94.1%, 81.6%, 74.2%, 57.2% and 0% (1-, 3-, 5-, 7- and 10-year survival, respectively) in patients with harmful relapse. There was a significant difference in survival (P = 0.019, Fig. 3). All 18 patients with harmful relapse had abnormal values of any hepatic chemistry, eight patients had abnormal pathological findings including steatosis in five and steatohepatitis in three,

and one patient had psychiatric problem relating mTOR inhibitor to alcoholism. Significant risk factors for harmful relapse were length of period of pretransplant abstinence shorter than 18 months, non-compliance with immunosuppression and smoking after transplantation in univariate analyses (Table 1). HRAR score had no relation to the incidence of harmful Poziotinib relapse (Table 1, Fig. 4). The incidence of harmful relapse in patients

of four groups divided according to length of period of pretransplant abstinence is shown in Figure 5. The incidence was 17.2%, 17.4%, 17.7% and 2.9% in patients with pretransplant abstinence shorter than 6 months, 6 months or longer and shorter than 12 months, 12 months or longer and shorter than 18 months, and 18 months or longer, respectively. However, there was no significant difference (P = 0.129). Taking the three groups with abstinence shorter than 18 months together, the incidence was significantly lower in patients with abstinence for 18 months or longer than in patients with abstinence shorter than 18 months (P = 0.031, Table 1). Risk factors for harmful relapse that were significant (P < 0.05) in the univariate analysis were chosen for the multivariate analysis. Length of period of pretransplant abstinence shorter than 18 months was a significant indicator for harmful relapse (P = 0.012) (Table 2). The incidence of harmful relapse was high when the donors were parents or siblings (40.0% and 25.0%, respectively), but lower when the donors were sons or daughters (5.5%), spouses (10.0%) 上海皓元 or non-relatives

(14.3%), although the difference was not significant (Table 1). The causes of death in the three groups are shown in Table 3. Malignancies including three hepatocellular carcinoma recurrence and infections were major causes in abstinent patients. One abstinent patient died due to chronic rejection. In patients with harmful relapse, infection was a cause of death in three patients, and graft failure with unknown reasons, disseminated intravascular coagulopathy, multiple organ failure, myocardial infarction and traffic accident were causes of death in one patient each. The infectious complications of the three patients were all sepsis including endocarditis secondary to hepatic abscess, severe infection after re-transplantation and unknown reasons.