Disease recurrence after living liver transplantation for primary biliary cirrhosis: A clinical and histological follow-up study

We describe the recurrence of primary biliary cirrhosis (PBC) in recipients of living liver transplants, We are not aware of similar previous reports, Because most donors for living liver transplantation (LLT) are blood relat ives with close HLA matches, the recurrence of PBC in transplant recipients : might offer additional insights in the pathogenesis of the condition. We studied 6 women (age, 23 to 61 years) with PBC who survived LLT for at leas t 1 year. Tests for antimitochondrial autoantibody (AMA), antipyruvate dehy drogenase complex-E2, immunoglobulin G (IgG) anti-M2, and IgM anti-M2 had c onfirmed the diagnosis, Donors were blood relatives in 5 instances, and one donor who was not a blood relative still had multiple HLA matches with the recipient. After LLT, we observed a decrease in AMA titers, but within 1 y ear, these titers increased again in 5 of the 6 patients to pre-LLT levels or greater, Immunoblotting analysis of the anti-M2 protein profile failed t o show loss of bands and showed new bands in 3 of 6 patients. Histologicall y, strong evidence of recurrent PBC was found in 2 patients, and findings c ompatible with PBC were present in 1 additional patient All 6 patients are doing well, without symptoms of recurrent PBC (median time post-LLT, 35.5 m onths; range, 12 to 50 months).