NDLI: Long-term outcomes of de novo autoimmune hepatitis in pediatric liver transplant recipients

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Long-term outcomes of de novo autoimmune hepatitis in pediatric liver transplant recipients

Content Provider	Scilit
Author	Ekong, Udeme D. McKiernan, Patrick Martinez, Mercedes Lobritto, Steven Kelly, Deirdre Ng, Vicky L. Alonso, Estella M. Avitzur, Yaron
Copyright Year	2017
Description	Journal: Pediatric Transplantation The long-term course and outcome of DAIH is unknown. A retrospective multicenter study assessing associations and long-term consequences of DAIH developing in a transplanted allograft is presented. Children with DAIH were followed from diagnosis until death, re-LT, or transfer of care and for a minimum of 1 year. A total of 31 patients of 1833 (1.7%) LT were identified; 29 followed for a median of 7.1 years (range, 1.6-15); 52% had no rejection preceding diagnosis of DAIH. Transaminases fell following treatment with steroids and antimetabolites (ALT 108 vs 39 U/L (P=.002); AST 112 vs 52 U/L (P=.003); GGT 72 vs 36 U/L (P=.03), but this was not universally sustained. Transaminases >2X ULN observed in 38% of patients at last follow-up; commonly GGT, attributed to bile duct injury and ductopenia. Portal hypertension (PHT) was seen in four patients and associated with severe fibrosis and cirrhosis. Re-LT occurred in two patients for chronic rejection (CR) and uncontrolled PHT with gastrointestinal bleeding, respectively. No deaths from DAIH were reported. DAIH is an uncommon complication following pediatric LT requiring prolonged and augmented immunosuppression. It is associated with continued allograft dysfunction and may lead to bile duct injury, CR, and PHT necessitating re-LT.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5570622/pdf
e-ISSN	13993046
DOI	10.1111/petr.12945
Journal	Pediatric Transplantation
Issue Number	6
Volume Number	21
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2017-05-29
Access Restriction	Open
Subject Keyword	Journal: Pediatric Transplantation Pediatrics and Child Health Allograft Dysfunction Chronic Rejection Liver Retransplantation Portal Hypertension
Content Type	Text
Resource Type	Article

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