Recurrence of autoimmune hepatitis cholestatic variant syndromes after liver transplantation affects graft and patient survival

作者：Vincenzo Ronca, Alessandro Parente, Ellina Lytvyak, Bettina E. Hansen, Gideon M. Hirschfield, Alan Bonder, Maryam Ebadi, Saleh Elwir, Mohamad Alsaed, Piotr Milkiewicz, Maciej K. Janik, Hanns–Ulrich Marschall, Maria Antonella Burza, Cumali Efe, Ali Rıza Çalışkan, Murat Harputluoğlu, Gökhan Kabaçam, Débora Raquel Benedita Terrabuio, Fernanda de Quadros Onófrio, Nazia Selzner, Albert Parés, Laura Patricia Llovet, Murat Akyıldız, Çiğdem Arıkan, M.P. Manns, Richard Taubert, Anna-Lena Weber, Thomas D. Schiano, Brandy Haydel, Piotr Czubkowski, Piotr Socha, Natalia Ołdak, Nobuhisa Akamatsu, Atsushi Tanaka, Cynthia Levy, Éric Martin, Aparna Goel, Mai Sedki, Irena Jankowska, Toru Ikegami, María José Rodríguez, Martina Sterneck, Marcial Sebode, Christoph Schramm, Maria Francesca Donato, Francesca Colapietro, Ansgar W. Lohse, Raúl J. Andrade, Vilas Patwardhan, Bart van Hoek, Maaike Biewenga, Andreas E. Kremer, Yoshihide Ueda, Mark Deneau, Mark Pedersen, Marlyn J. Mayo, Annarosa Floreani, Patrizia Burra, Maria Francesca Secchi, Benedetta Terziroli Beretta‐Piccoli, Marco Sciveres, Giuseppe Maggiore, Syed‐Mohammed Jafri, Dominique Debray, M Girard, Florence Lacaille, Michael A. Heneghan, Andrew L. Mason, Ye Htun Oo, Aldo J. Montaño‐Loza · 发表于：JHEP Reports · 年份：2025 · DOI：10.1016/j.jhepr.2025.101332 · 被引用次数：2 · 研究领域：Liver Diseases and Immunity、Pediatric Hepatobiliary Diseases and Treatments、Organ Transplantation Techniques and Outcomes

Background & Aims A significant proportion of patients with variant syndromes (VSs), namely autoimmune hepatitis/primary biliary cholangitis or autoimmune hepatitis/primary sclerosing cholangitis, require liver transplantation (LT) despite treatment. The frequency of disease recurrence and the effect on graft survival are yet to be clarified. The aim of this international, multicentric, retrospective study is to evaluate the risk factors associated with recurrence and the impact of the disease recurrence after LT on graft and patient survival. Methods We evaluated 166 patients undergoing LT for VS in 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 with a higher risk of recurrence of autoimmune disease based on a histological and radiological diagnosis. Cumulative probabilities of graft and overall survival after LT were calculated using a semi-Markov model. Results The autoimmune pattern of recurrence resembled the original VS in 19 cases (61%). Recurrence of autoimmune liver disease ( r ALD) after LT was observed in 23% and 33% of patients after 5 and 10 years, respectively. Increased alkaline phosphatase (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.13–2.25, p <0.01) and alanine aminotransferase (HR 1.25, 95% CI 1.01–1.53, p = 0.03) at 12 months after LT and acute rejection (HR 3.58, 95% CI 1.60–7....