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21 May 2009

The outcome of liver transplantation in autoimmune hepatitis

U Ołdakowska-Jedynak, P Nyckowski, K Zieniewicz, T Wróblewski, R Paluszkiewicz, B Górnicka, B Ziarkiewicz-Wróblewska, L Pączek, B Foroncewicz, A Kącka, , M Krawczyk

Ann Transplant 2009; 14(1): 29-29 :: ID: 880304

Abstract

Autoimmune hepatitis (AIH) is an indication for liver transplantation (OLTx).
OLTx is offered to patients with fulminant or subfulminant and patients with
decompensated liver cirrhosis, but its post-transplant course remains controversial and pts transplanted for AIH comprise a group of special interest. The aim of this study was to evaluate clinical outcome after OLTx in these patients at a single institution. Patients and methods. Retrospective data was collected from pts transplanted at our centre from December 1989 until January 2004. A total of 256 OLTx was performed. 12 pts were transplanted for AIH. There were 3 men and 9 women. This patient cohort comprised 5% of the total transplants over that period. All pts presented with type I AIH. Initial immunosuppressive medication was induction with the use of basiliximab 20 mg on day 0 and 4 in combination with tacrolimus-based regimen in most cases. Steroid therapy was never discontinued during the study period. We did not perform protocol liver biopsies. Results. Mean age of recipients was 30.3±10.9 years-old. They are younger than recipients transplanted for another causes than AIH 40.4±11.8 years-old, and mostly female. Autoantibodies and hypergammaglobulinemia disappeared in most pts within 2 years. Acute rejection (AR) episode was not frequent and occurred in 27% of pts. There was no correlation between antibodies persistence and graft rejection episodes. No recurrence of AIH was observed during the follow-up after OLTx. One pt developed clinical symptoms with presumed recurrence which was not confi rmed by biopsy. However, the majority of this pts' group experienced high incidence, at least one episode, of bacterial infection 82% (9 pts) and CMV infection 73% (8 pts). The patient's and graft's survival rates for this group at 1, 5 and 7 years was 92%, 81.5%, 81.5% and 83%, 73%, 73% respectively.

Keywords: Liver Transplantation, clinical outcome

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358