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Semin Liver Dis 2002; 22(4): 379-386
DOI: 10.1055/s-2002-35707
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Transplantation for Autoimmune Hepatitis

James Neuberger
  • Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom
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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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 3 Devlin J, O'Grady J. Indications for referral and assessment in adult liver transplantation.  Gut . 1999;  45(Suppl VI) VI1-VI22
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 8 Neuberger J. Incidence, timing and risk factors for acute and chronic rejection.  Liver Transpl Surg . 1999;  5(Suppl 5) S30-S36
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 10 Reich D J, Fiel I, Guarrera J V. Liver transplantation for autoimmune hepatitis.  Hepatology . 2000;  32 693-700
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 13 Devlin J, Doherty D, Thomson L. Defining the outcome of immunosuppression withdrawal after liver transplantation.  Hepatology . 1998;  27 926-933
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 15 Hubscher S G. Recurrent autoimmune hepatitis after liver transplantation: diagnostic criteria, risk factors and outcome.  Liver Transplantation . 2001;  7 285-291
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 18 Manns M P, Bahr M J. Recurrent autoimmune hepatitis after liver transplantation-when self becomes non-self.  Hepatology . 2000;  32 868-870
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 20 Gonzalez-Koch A, Czaja A J, Carpenter H A. Recurrent autoimmune hepatitis after orthotopic liver transplantation.  Liver Transplantation . 2001;  7 302-310
    CrossrefPubMedSearch in Google Scholar
  • 21 Ayata G, Gordon F D, Lewis W D. Liver transplantation for autoimmune hepatitis: a long-term pathologic study.  Hepatology . 2000;  32 185-192
    CrossrefPubMedSearch in Google Scholar
  • 22 Milkiewicz P, Hubscher S, Skiba G, Hathaway M, Elias E. Recurrence of autoimmune hepatitis after liver transplantation.  Transplantation . 1999;  68 253-256
    CrossrefPubMedSearch in Google Scholar
  • 23 Salcedo M, Vaquero J, Banares R. Response to steroids in de novo autoimmune hepatitis after liver transplantation.  Hepatology . 2002;  35 349-365
    CrossrefPubMedSearch in Google Scholar
  • 24 Prados E, Cuervas-Mons V, de la Mata M. Outcome of autoimmune hepatitis after liver transplantation.  Transplantation . 1998;  66 1645-1650
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 28 Kerkar N, Hadzic N, Davies E T. De-novo autoimmune hepatitis after liver transplantation.  Lancet . 1998;  351 409-413
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar