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DOI: 10.1055/s-2002-35707
Transplantation for Autoimmune Hepatitis
Publication History
Publication Date:
25 November 2002 (online)
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ABSTRACT
Autoimmune hepatitis (AIH) is a good indication for liver transplantation, with 5- and 10-year survival rates approaching 75%. Determining the timing for transplantation remains difficult because progression to end-stage disease may be difficult to predict. After transplantation, the patients are at risk of recurrent AIH. This syndrome is not well-characterized and requires clearer definition. Introduction of corticosteroids is not always associated with arrest of disease. De novo AIH may also develop in the allograft. Although there is usually a good response to the reintroduction of corticosteroids or greater immunosuppression, some patients develop graft failure. Patients grafted for AIH tend to be at higher risk for both acute and chronic rejection. Withdrawal of immunosuppression is unlikely to be achieved.
KEYWORDS
Autoimmune hepatitis - liver transplantation - recurrent autoimmune hepatitis
REFERENCES
- 1 Poynard T, Naveau S, Doffoel M. Evaluation of efficacy of liver transplantation in alcoholic cirrhosis using matched and simulated controls: 5 year survival. J Hepatol . 1999; 30 1130-1137
- 2 Liermann Garcia F R, Evangelista Garcia C, McMaster P, Neuberger J. Transplantation for primary biliary cirrhosis: retrospective analysis of 400 patients in a single center. Hepatology . 2001; 33 22-27
- 3 Devlin J, O'Grady J. Indications for referral and assessment in adult liver transplantation. Gut . 1999; 45(Suppl VI) VI1-VI22
- 4 Lucey M, Brown K A, Everson G T. Minimal criteria for placement of adults on the liver transplant waiting list. Transplantation . 1998; 66 956-962
- 5 Harrison J, McKiernan J, Neuberger J. A prospective study on the effect of recipient nutritional status on outcome in liver transplantation. Transpl Int . 1997; 10 369-374
- 6 Milkiewicz P, Ahmed M, Hathaway M, Elias E. Factors associated with progression of disease before transplantation in patients with autoimmune hepatitis. Liver . 1999; 19 50-54
- 7 Wiesner R H, Demetris A J, Belle S H. Acute hepatic allograft rejection: incidence, risk factors and impact on outcome. Hepatology . 1998; 28 638-645
- 8 Neuberger J. Incidence, timing and risk factors for acute and chronic rejection. Liver Transpl Surg . 1999; 5(Suppl 5) S30-S36
- 9 Milkiewicz P, Gunson B, Saksena S. Increased incidence of chronic rejection in patients transplanted for autoimmune hepatitis: assessment of risk factors. Transplantation . 2000; 70 477-480
- 10 Reich D J, Fiel I, Guarrera J V. Liver transplantation for autoimmune hepatitis. Hepatology . 2000; 32 693-700
- 11 Hayashi M, Keefe E B, Krams S M. Allograft rejection after liver transplantation for autoimmune liver diseases. Liver Transpl Surg . 1998; 4 208-214
- 12 Trouillot T E, Shrestha R, Kam I, Wachs M, Everson G T. Successful withdrawal of prednisolone after adult liver transplantation for autoimmune hepatitis. Liver Transpl Surg . 1999; 5 375-380
- 13 Devlin J, Doherty D, Thomson L. Defining the outcome of immunosuppression withdrawal after liver transplantation. Hepatology . 1998; 27 926-933
- 14 Neuberger J, Portmann B, Calne R Y, Williams R. Recurrence of autoimmune chronic active hepatitis following orthotopic liver grafting. Transplantation . 1984; 37 363-365
- 15 Hubscher S G. Recurrent autoimmune hepatitis after liver transplantation: diagnostic criteria, risk factors and outcome. Liver Transplantation . 2001; 7 285-291
- 16 Alvarez F, Berg P A, Bianchi F B. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol . 1999; 31 929-938
- 17 Dubel L, Farges O, Johanet C, Sebagh M, Bismuth H. High incidence of anti-tissue antibodies in patients experiencing chronic liver allograft rejection. Transplantation . 1998; 65 1072-1075
- 18 Manns M P, Bahr M J. Recurrent autoimmune hepatitis after liver transplantation-when self becomes non-self. Hepatology . 2000; 32 868-870
- 19 Sempoux C, Horsmans Y, Lerut J, Rahier J, Guebel A. Acute lobular hepatitis as the first manifestation of recurrent autoimmune hepatitis after orthotopic liver transplantation. Liver . 1997; 17 311-315
- 20 Gonzalez-Koch A, Czaja A J, Carpenter H A. Recurrent autoimmune hepatitis after orthotopic liver transplantation. Liver Transplantation . 2001; 7 302-310
- 21 Ayata G, Gordon F D, Lewis W D. Liver transplantation for autoimmune hepatitis: a long-term pathologic study. Hepatology . 2000; 32 185-192
- 22 Milkiewicz P, Hubscher S, Skiba G, Hathaway M, Elias E. Recurrence of autoimmune hepatitis after liver transplantation. Transplantation . 1999; 68 253-256
- 23 Salcedo M, Vaquero J, Banares R. Response to steroids in de novo autoimmune hepatitis after liver transplantation. Hepatology . 2002; 35 349-365
- 24 Prados E, Cuervas-Mons V, de la Mata M. Outcome of autoimmune hepatitis after liver transplantation. Transplantation . 1998; 66 1645-1650
- 25 Ratziu V, Samuel D, Sebagh M. Long-term follow-up after liver transplantation for autoimmune hepatitis: evidence of recurrence of primary disease. J Hepatol . 1999; 30 131-141
- 26 Bahar R J, Yanni G S, Martin M G. Orthotopic liver transplantation for autoimmune hepatitis and cryptogenic chronic hepatitis in children. Transplantation . 2001; 72 829-833
- 27 Hurtova M, Duclos-Vallee J C, Johanet C. Successful tacrolimus therapy for a severe recurrence of type 1 autoimmune hepatitis in a liver allograft recipient. Liver Transplantation . 2001; 7 556-558
- 28 Kerkar N, Hadzic N, Davies E T. De-novo autoimmune hepatitis after liver transplantation. Lancet . 1998; 351 409-413
- 29 Heneghan M A, Portmann B C, Norris S M. Graft dysfunction mimicking autoimmune hepatitis following liver transplantation in adults. Hepatology . 2001; 34 464-470
- 30 Andries S, Casamayou L, Sempoux C. Post-transplant immune hepatitis in pediatric liver transplant recipients: incidence and maintenance therapy with azathioprine. Transplantation . 2001; 72 267-272
- 31 Gupta P, Hart J, Millis J M, Cronin D, Brady L. De novo hepatitis with autoimmune antibodies and atypical histology: a rare cause of late graft dysfunction after paediatric liver transplantation. Transplantation . 2001; 71 664-668
- 32 Molmenti E P, Netto F S, Murray N G. Incidence and recurrence of autoimmune/alloimmune hepatitis in liver transplant recipients. Liver Transpl . 2002; 8 519-526
- 33 Jones D E, James O F, Portmann B. Development of autoimmune hepatitis following liver transplantation for primary biliary cirrhosis. Hepatology . 2000; 30 53-57
- 34 Tan C K, Sian Ho M J. Concurrent de novo autoimmune hepatitis and recurrence of primary biliary cirrhosis post-liver transplantation. Liver Transplantation . 2001; 7 461-465
- 35 Aguilera I, Wichman I, Sousa J M. Antibodies against glutathione-S-transferase TI (GSTTI) in patients with de novo immune hepatitis following liver transplantation. Clin Exp Immunol . 2001; 126 535-539
- 36 Lohse A W, Obermayer-Straub P, Gerken G. Development of cytochrome P450 2D6-specific LKM-autoantibodies following liver transplantation for Wilson's disease-possible association with a steroid-resistant rejection episode. J Hepatol . 1999; 31 149-155