About 10% of patients with autoimmune hepatitis (AIH) do not respond to medical therapy. Liver transplantation is the final therapeutic option for these patients
In this study, researchers from Germany evaluated the long-term outcome in serologically defined subgroups of AIH after transplantation.
The team included 28 patients with AIH who were transplanted between 1987 and 1999. These patients were compared with 24 patients who underwent liver transplantation due Wilson's disease and glycogen storage disease type 1.
Serological analyses identified patients with AIH type 1 (n = 13), type 2 (n = 5), and type 3 (n = 10).
The team determined that the 5-yr patient survival rate after liver transplantation was 78%. There was no difference in survival between the patients and controls.
|Autoimmune hepatitis recurred in 32%.|
The researchers found that 6 AIH patients and 4 control patients required re-transplantation because of initial non-function, chronic rejection or AIH recurrence.
They determined that patients transplanted for AIH (88%) had more episodes of acute rejection when compared with patients transplanted for genetic liver diseases (50%).
Clinical and histological features of chronic rejection were present in 4 AIH patients. Again, there was do difference between the patient and control groups.
The team diagnosed AIH recurrence in 9 patients (32%). This was based on the presence of autoantibodies, increased gamma-globulins, steroid dependency, and histological evidence of chronic hepatitis. These combined features were not found in any of the controls.
Dr Arndt Vogela's team concluded, "Our data do not suggest that AIH subtypes influence prognosis after liver transplantation".
"Despite a high frequency of acute cellular rejection episodes and disease recurrence, transplantation for AIH has a 5-year survival rate, which does not differ from that observed in patients transplanted for genetic liver diseases".