RT Journal Article
T1 Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation.
A1 Montano-Loza, Aldo J
A1 Ronca, Vincenzo
A1 Ebadi, Maryam
A1 Hansen, Bettina E
A1 Hirschfield, Gideon
A1 Elwir, Saleh
A1 Alsaed, Mohamad
A1 Milkiewicz, Piotr
A1 Janik, Maciej K
A1 Marschall, Hanns-Ulrich
A1 Burza, Maria Antonella
A1 Efe, Cumali
A1 Calışkan, Ali Rıza
A1 Harputluoglu, Murat
A1 Kabaçam, Gökhan
A1 Terrabuio, Débora
A1 de Quadros Onofrio, Fernanda
A1 Selzner, Nazia
A1 Bonder, Alan
A1 Parés, Albert
A1 Llovet, Laura
A1 Akyıldız, Murat
A1 Arikan, Cigdem
A1 Manns, Michael P
A1 Taubert, Richard
A1 Weber, Anna-Lena
A1 Schiano, Thomas D
A1 Haydel, Brandy
A1 Czubkowski, Piotr
A1 Socha, Piotr
A1 Ołdak, Natalia
A1 Akamatsu, Nobuhisa
A1 Tanaka, Atsushi
A1 Levy, Cynthia
A1 Martin, Eric F
A1 Goel, Aparna
A1 Sedki, Mai
A1 Jankowska, Irena
A1 Ikegami, Toru
A1 Rodriguez, Maria
A1 Sterneck, Martina
A1 Weiler-Normann, Christina
A1 Schramm, Christoph
A1 Donato, Maria Francesca
A1 Lohse, Ansgar
A1 Andrade, Raul J
A1 Patwardhan, Vilas R
A1 van Hoek, Bart
A1 Biewenga, Maaike
A1 Kremer, Andreas E
A1 Ueda, Yoshihide
A1 Deneau, Mark
A1 Pedersen, Mark
A1 Mayo, Marlyn J
A1 Floreani, Annarosa
A1 Burra, Patrizia
A1 Secchi, Maria Francesca
A1 Beretta-Piccoli, Benedetta Terziroli
A1 Sciveres, Marco
A1 Maggiore, Giuseppe
A1 Jafri, Syed-Mohammed
A1 Debray, Dominique
A1 Girard, Muriel
A1 Lacaille, Florence
A1 Lytvyak, Ellina
A1 Mason, Andrew L
A1 Heneghan, Michael
A1 Oo, Ye Htun
A1 International Autoimmune Hepatitis Group (IAIHG), 
K1 autoimmune liver disease
K1 graft survival
K1 liver transplantation
K1 recurrent disease
K1 survival
AB Autoimmune hepatitis can recur after liver transplantation (LT), though the impact of recurrence on patient and graft survival has not been well characterized. We evaluated a large, international, multicenter cohort to identify the probability and risk factors associated with recurrent AIH and the association between recurrent disease and patient and graft survival. We included 736 patients (77% female, mean age 42±1 years) with AIH who underwent LT from January 1987 through June 2020, among 33 centers in North America, South America, Europe and Asia. Clinical data before and after LT, biochemical data within the first 12 months after LT, and immunosuppression after LT were analyzed to identify patients at higher risk of AIH recurrence based on histological diagnosis. AIH recurred in 20% of patients after 5 years and 31% after 10 years. Age at LT ≤42 years (hazard ratio [HR] 3.15; 95% CI 1.22-8.16; p = 0.02), use of mycophenolate mofetil post-LT (HR 3.06; 95% CI 1.39-6.73; p = 0.005), donor and recipient sex mismatch (HR 2.57; 95% CI 1.39-4.76; p = 0.003) and high IgG pre-LT (HR 1.04; 95% CI 1.01-1.06; p = 0.004) were associated with higher risk of AIH recurrence after adjusting for other confounders. In multivariate Cox regression, recurrent AIH (as a time-dependent covariate) was significantly associated with graft loss (HR 10.79, 95% CI 5.37-21.66, p  Recurrence of AIH following transplant is frequent and is associated with younger age at LT, use of mycophenolate mofetil post-LT, sex mismatch and high IgG pre-LT. We demonstrate an association between disease recurrence and impaired graft and overall survival in patients with AIH, highlighting the importance of ongoing efforts to better characterize, prevent and treat recurrent AIH. Recurrent autoimmune hepatitis following liver transplant is frequent and is associated with some recipient features and the type of immunosuppressive medications use. Recurrent autoimmune hepatitis negatively affects outcomes after liver transplantation. Thus, improved measures are required to prevent and treat this condition.
YR 2022
FD 2022-02-08
LK http://hdl.handle.net/10668/22313
UL http://hdl.handle.net/10668/22313
LA en
DS RISalud
RD Apr 10, 2025