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Titolo:
Recurrent autoimmune hepatitis after orthotopic liver transplantation
Autore:
Gonzalez-Koch, A; Czaja, AJ; Carpenter, HA; Roberts, SK; Charlton, MR; Porayko, MK; Rosen, CB; Wiesner, RH;
Indirizzi:
Mayo Clin & Mayo Fdn, Div Gastroenterol & Hepatol, Rochester, MN 55905 USAMayo Clin & Mayo Fdn Rochester MN USA 55905 atol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Dept Lab Med & Pathol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 thol, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Div Transplantat Surg, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Surg, Rochester, MN 55905 USA
Titolo Testata:
LIVER TRANSPLANTATION
fascicolo: 4, volume: 7, anno: 2001,
pagine: 302 - 310
SICI:
1527-6465(200104)7:4<302:RAHAOL>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC ACTIVE HEPATITIS; ALLOGRAFT-REJECTION; GENETIC PREDISPOSITIONS; IMMUNOLOGICAL FEATURES; RISK-FACTORS; DISEASE; SUSCEPTIBILITY; POLYMORPHISMS; SPECIFICITY; MECHANISMS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
53
Recensione:
Indirizzi per estratti:
Indirizzo: Czaja, AJ Mayo Clin & Mayo Fdn, Div Gastroenterol & Hepatol, 200 1st St SW, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn 200 1st St SW Rochester MN USA 55905 05 USA
Citazione:
A. Gonzalez-Koch et al., "Recurrent autoimmune hepatitis after orthotopic liver transplantation", LIVER TRANS, 7(4), 2001, pp. 302-310

Abstract

To determine the frequency, risk factors, and consequences of recurrent autoimmune hepatitis after liver transplantation, 41 patients with type 1 disease were monitored after surgery in accordance with a surveillance protocol. Tacrolimus or cyclosporine plus prednisone were administered to each patient, and liver biopsy examinations were performed at least annually according to protocol. Corticosteroid therapy was ultimately discontinued in only2 patients. Recurrent disease was defined as the presence of lymphoplasmacytic infiltrates in liver tissue in the absence of other causes of allogaftdysfunction. Autoimmune hepatitis recurred in 7 patients (17%), and the mean time to recurrence was 4.6 +/- 1 years. Recurrence was asymptomatic in 4of 7 patients and detected only by surveillance liver biopsy assessment in2 patients. Histological changes were mild, and there was no progression to cirrhosis during 4.9 +/- 0.9 years of observation. Five-year patient (86%v 82%; P = .9) and graft (86% v 67%; P = .5) survival rates were not statistically different between patients with and without recurrent disease. HLA-DR3 or HLA-DR4 occurred more commonly in patients with than without recurrence (100% v 40%; P = .008) and healthy subjects (100% v 40%; P = .01). Recurrent disease was unrelated to donor HLA status. In conclusion, recurrenceafter transplantation for type 1 autoimmune hepatitis is common. Its mild manifestations and favorable prognosis may reflect early detection by a surveillance protocol and/or continuous corticosteroid treatment. HLA-DR3- or HLA-DR4-positive recipients are at risk for recurrence regardless of donor HLA status.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/01/20 alle ore 14:42:04