Recurrence of autoimmune hepatitis after liver transplantation

Background. The literature data on the recurrence of autoimmune hepatitis (AIH) after orthotopic liver transplantation (OLTX) is scanty. Methods. We analyzed the frequency of recurrent AIH in 47 patients who had been transplanted for AIH and survived at least 1 year after surgery. The following criteria were applied to diagnose recurrence: (1) positive autoantibodies in the titer greater than or equal to 1:40; (2) hypertransaminasemia; (3) histological features of chronic hepatitis; (4) need of reintroduction or significant increase of steroids; and (5) lack of serum markers of viral hepatitis. Results. A total of 13 patients (1 male/12 females) developed recurrent AIH after an interval of 6-63 months after OLTX (mean 29 months). Mean AST level at recurrence was 542+/-129 U/L. Three patients from this group needed regrafting. Mismatch of DR3(+) recipient and. DR3(-) donor was not more common in the recurrent disease group (37%) compared to the nonrecurrence group (31%) (P=NS). Conclusions. Recurrence of AIH after OLTX was diagnosed in a high proportion of patients and some of them required regrafting. DR3(+) patients are not particularly prone to develop recurrence.