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 f ollowing criteria were applied to diagnose recurrence: (1) positive autoant ibodies in the titer greater than or equal to 1:40; (2) hypertransaminasemi a; (3) histological features of chronic hepatitis; (4) need of reintroducti on or significant increase of steroids; and (5) lack of serum markers of vi ral 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 lev el at recurrence was 542+/-129 U/L. Three patients from this group needed r egrafting. Mismatch of DR3(+) recipient and. DR3(-) donor was not more comm on 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 proportio n of patients and some of them required regrafting. DR3(+) patients are not particularly prone to develop recurrence.