Incidence and recurrence of autoimmune/alloimmune hepatitis in liver transplant recipients

We prospectively collected data on 1,429 liver transplant recipients between December 1984 and December 1998. Fifty-five patients (3.8%; 10 men, 45 women; median age, 44.5 ± 13 [SD] years) with autoimmune hepatitis (AIH) underwent orthotopic liver transplantation (OLT). Transplant recipients with AI...

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Bibliographic Details
Published in:Liver transplantation 2002-06, Vol.8 (6), p.519-526
Main Authors: Molmenti, Ernesto P., Netto, George J., Murray, Natalie G., Smith, Douglas M., Molmenti, Hebe, Crippin, Jeffrey S., Hoover, Tyrone C., Jung, Ghapjoong, Marubashi, Shigeru, Sanchez, Edmund Q., Gogel, Brian, Levy, Marlon F., Goldstein, Robert M., Fasola, Carlos G., Gonwa, Thomas A., Klintmalm, Goran B.
Format: Article
Language:English
Subjects:
Adult
Age
Autoimmune diseases
Azathioprine - therapeutic use
Cyclophosphamide - therapeutic use
Data processing
Female
Graft Rejection
Graft Survival
Hepatitis
Hepatitis, Autoimmune - etiology
Hepatitis, Autoimmune - mortality
Hepatitis, Autoimmune - pathology
Humans
Immunosuppressive Agents - therapeutic use
Liver Function Tests
Liver transplantation
Liver Transplantation - adverse effects
Male
Middle Aged
Mimicry
Recurrence
Retrospective Studies
Survival
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Summary:We prospectively collected data on 1,429 liver transplant recipients between December 1984 and December 1998. Fifty-five patients (3.8%; 10 men, 45 women; median age, 44.5 ± 13 [SD] years) with autoimmune hepatitis (AIH) underwent orthotopic liver transplantation (OLT). Transplant recipients with AIH were younger, more likely to be women, and had a greater likelihood of rejection in the first 3, 6, and 12 months. There was no difference in patient survival or graft survival. There were 11 biopsy-proven recurrences (1 man, 10 women) of AIH after OLT. Almost half the episodes occurred within the first year after OLT. No patient required re-OLT because of recurrent disease. AIH has an incidence of 4% and a recurrence rate of 20% in OLT. Transplant recipients are more likely to be young women and have an increased incidence of acute cellular rejection (ACR) during the first post-OLT year. Recurrence should be suspected in those with abnormal liver function test results in the absence of ACR, especially during the first year after OLT. We cannot establish with certainty whether the observed process represents recurrence of the original autoimmune disease, an alloimmune phenomenon, or allograft dysfunction mimicking AIH. ( Liver Transpl 2002;8:519-526.)
ISSN:1527-6465
1527-6473
DOI:10.1053/jlts.2002.32981