Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation

Basit Öğe Kaydı
dc.authoridGirard, Muriel/0000-0003-0050-1035
dc.authoridHarputluoglu, Muhsin Murat Muhip/0000-0002-9415-147X
dc.authoridPares, Albert/0000-0002-5413-9687
dc.authoridSelzner, Nazia/0000-0002-9435-2597
dc.authoridBurra, Patrizia/0000-0002-8791-191X
dc.authoridRonca, Vincenzo/0000-0003-0761-1333
dc.authoridLytvyak, Ellina/0000-0001-5651-9010
dc.authorwosidGirard, Muriel/B-7156-2018
dc.authorwosidOo, Ye Htun/AFC-8888-2022
dc.authorwosidHarputluoglu, Muhsin Murat Muhip/ABI-3094-2020
dc.authorwosidMontano-Loza, Aldo J./B-3092-2013
dc.authorwosidPares, Albert/G-1328-2011
dc.authorwosidIkegami, Toru/GRI-9889-2022
dc.authorwosidUeda, Yoshihide/S-7620-2016
dc.contributor.authorMontano-Loza, Aldo J.
dc.contributor.authorRonca, Vincenzo
dc.contributor.authorEbadi, Maryam
dc.contributor.authorHansen, Bettina E.
dc.contributor.authorHirschfield, Gideon
dc.contributor.authorElwir, Saleh
dc.contributor.authorAlsaed, Mohamad
dc.date.accessioned2024-08-04T20:51:49Z
dc.date.available2024-08-04T20:51:49Z
dc.date.issued2022
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground & Aims: Autoimmune hepatitis can recur after liver transplantation (LT), though the impact of recurrence on patient and graft survival has not been well characterized. We evaluated a large, international, multicenter cohort to identify the probability and risk factors associated with recurrent AIH and the association between recurrent disease and patient and graft survival. Methods: We included 736 patients (77% female, mean age 42 +/- 1 years) with AIH who underwent LT from January 1987 through June 2020, among 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 at higher risk of AIH recurrence based on histological diagnosis. Results: AIH recurred in 20% of patients after 5 years and 31% after 10 years. Age at LT <= 42 years (hazard ratio [HR] 3.15; 95% CI 1.22-8.16; p = 0.02), use of mycophenolate mofetil post-LT (HR 3.06; 95% CI 1.39-6.73; p = 0.005), donor and recipient sex mismatch (HR 2.57; 95% CI 1.39-4.76; p = 0.003) and high IgG pre-LT (HR 1.04; 95% CI 1.01-1.06; p = 0.004) were associated with higher risk of AIH recurrence after adjusting for other confounders. In multivariate Cox regression, recurrent AIH (as a time-dependent covariate) was significantly associated with graft loss (HR 10.79, 95% CI 5.37-21.66, p <0.001) and death (HR 2.53, 95% CI 1.48-4.33, p = 0.001). Conclusion: Recurrence of AIH following transplant is frequent and is associated with younger age at LT, use of mycophenolate mofetil post-LT, sex mismatch and high IgG pre-LT. We demonstrate an association between disease recurrence and impaired graft and overall survival in patients with AIH, highlighting the importance of ongoing efforts to better characterize, prevent and treat recurrent AIH. Lay summary: Recurrent autoimmune hepatitis following liver transplant is frequent and is associated with some recipient features and the type of immunosuppressive medications use. Recurrent autoimmune hepatitis negatively affects outcomes after liver transplantation. Thus, improved measures are required to prevent and treat this condition. (C) 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.en_US
dc.description.sponsorshipUniversity of Alberta Hospital Foundation (UHF); Canadian Liver Foundation (CLF); Canadian Institutes of Health Research (CIHR) -Institute of Nutrition, Metabolism,and Diabetes (INMD) Fellowship - Hepatology; Canadian Association for the Study of the Liver (CASL); Sir Jules Thorn Biomedical Research Award; Transbioline Innovative Medicine Initiatives; Medical Research Foundation; MRC; Queen Elizabeth Hospital Birming-ham Charity; EASL; EASL Juan Rodes PhD fellowship programmeen_US
dc.description.sponsorshipAldo J. Montano-Loza receives funding from the University of Alberta Hospital Foundation (UHF) and the Canadian Liver Foundation (CLF) . Maryam Ebadi receives funding from the Canadian Institutes of Health Research (CIHR) -Institute of Nutrition, Metabolism,and Diabetes (INMD) Fellowship - Hepatology, in partnership with the Canadian Association for the Study of the Liver (CASL) and the Canadian Liver Foundation (CLF) . Ye Htun Oo receives funding from Sir Jules Thorn Biomedical Research Award, Transbioline Innovative Medicine Initiatives, Medical Research Foundation, MRC, Queen Elizabeth Hospital Birming-ham Charity and EASL. Vincenzo Ronca receives funding from EASL Juan Rodes PhD fellowship programme.en_US
dc.identifier.doi10.1016/j.jhep.2022.01.022
dc.identifier.endpage97en_US
dc.identifier.issn0168-8278
dc.identifier.issn1600-0641
dc.identifier.issue1en_US
dc.identifier.pmid35143897en_US
dc.identifier.scopus2-s2.0-85127328871en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage84en_US
dc.identifier.urihttps://doi.org/10.1016/j.jhep.2022.01.022
dc.identifier.urihttps://hdl.handle.net/11616/100574
dc.identifier.volume77en_US
dc.identifier.wosWOS:000833420200012en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofJournal of Hepatologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectautoimmune liver diseaseen_US
dc.subjectrecurrent diseaseen_US
dc.subjectsurvivalen_US
dc.subjectgraft survivalen_US
dc.subjectliver transplantationen_US
dc.titleRisk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantationen_US
dc.typeArticleen_US

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu