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Multicenter Study
. 2023 Apr;43(4):906-916.
doi: 10.1111/liv.15500. Epub 2023 Jan 6.

Liver transplantation for autoimmune hepatitis: Pre-transplant does not predict the early post-transplant outcome

Yasmina Chouik  1   2 , Claire Francoz  3 , Eleonora De Martin  4 , Olivier Guillaud  1 , Armand Abergel  5 , Mario Altieri  6 , Louise Barbier  7 , Camille Besch  8 , Olivier Chazouillères  9 , Filomena Conti  10 , Christophe Corpechot  9 , Sébastien Dharancy  11 , François Durand  3 , Christophe Duvoux  12 , Jean Gugenheim  13 , Jean Hardwigsen  14 , Marie-Noëlle Hilleret  15 , Pauline Houssel-Debry  16 , Nassim Kamar  17 , Anne Minello  18 , Martine Neau-Cransac  19 , Georges-Philippe Pageaux  20 , Sylvie Radenne  2 , Olivier Roux  3 , Faouzi Saliba  4 , Didier Samuel  4 , Claire Vanlemmens  21 , Marie-Lorraine Woehl-Jaegle  8 , Vincent Leroy  15 , Jean-Charles Duclos-Vallée  4 , Jérôme Dumortier  1
Affiliations
Multicenter Study

Liver transplantation for autoimmune hepatitis: Pre-transplant does not predict the early post-transplant outcome

Yasmina Chouik et al. Liver Int. 2023 Apr.

Abstract

Background and aims: Autoimmune hepatitis (AIH) is a rare indication (<5%) for liver transplantation (LT). The aim of this study was to describe the early outcome after LT for AIH.

Methods: A multicenter retrospective nationwide study including all patients aged ≥16 transplanted for AIH in France was conducted. Occurrences of biliary and vascular complications, rejection, sepsis, retransplantation and death were collected during the first year after LT.

Results: A total of 344 patients (78.8% of women, 17.0% of (sub)fulminant hepatitis and 19.2% of chronic liver diseases transplanted in the context of acute-on-chronic liver failure [ACLF]) were included, with a median age at LT of 43.6 years. Acute rejection, sepsis, biliary and vascular complications occurred in respectively 23.5%, 44.2%, 25.3% and 17.4% of patients during the first year after LT. One-year graft and patient survivals were 84.3% and 88.0% respectively. The main cause of early death was sepsis. Pre-LT immunosuppression was not associated with an increased risk for early infections or surgical complications. Significant risk factors for septic events were LT in the context of (sub)fulminant hepatitis or ACLF, acute kidney injury at the time of LT (AKI) and occurrence of biliary complications after LT. AKI was the only independent factor associated with graft (HR = 2.5; 95% CI: 1.1-5.4; p = .02) and patient survivals (HR = 2.6; 95% CI: 1.0-6.5; p = .04).

Conclusion: Early prognosis is good after LT for AIH and is not impacted by pre-LT immunosuppression but by the presence of AKI at the time of LT.

Keywords: early infection; fulminant hepatitis; immunosuppression; sepsis; survival.

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References

REFERENCES

    1. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: autoimmune hepatitis. J Hepatol. 2015;63:971-1004.
    1. Hoeroldt B, McFarlane E, Dube A, et al. Long-term outcomes of patients with autoimmune hepatitis managed at a nontransplant center. Gastroenterology. 2011;140:1980-1989.
    1. Biewenga M, Verhelst X, Baven-Pronk M, et al. Aminotransferases during treatment in AIH aminotransferases during treatment predict long-term survival in patients with autoimmune hepatitis type 1: a landmark analysis. Clin Gastroenterol Hepatol. 2021;8:1776-1783.
    1. Biewenga M, Verhelst X, Baven-Pronk M, et al. Development and validation of a prognostic score for long-term transplant-free survival in autoimmune hepatitis type 1. United European Gastroenterol J. 2021;9(6):662-671.
    1. de Vaca VGC, Bernal Bellido C, Alamo Martínez JN, et al. Liver transplantation due to fulminant hepatic failure. Transplant Proc. 2012;44:2076-2077.

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