Outcome of orthotopic liver transplantation in autoimmune hepatitis according to subtypes

Transpl Int. 2002 Jan;15(1):34-8. doi: 10.1007/s00147-001-0376-7. Epub 2002 Jan 18.

Abstract

The relevance of autoimmune hepatitis (AIH) classification for clinical purposes is controversial. We analyzed the outcome after orthotopic liver transplantation (OLT) of nine type I and seven type II AIH patients. Type II patients had a significantly higher incidence of cirrhosis at the time of diagnosis, more resistance to steroid therapy, and a higher Child-Pugh score at the time of OLT. OLT was performed in emergency in three type II patients and electively in all type I patients. Four type II and one type I patients died in the postoperative period. There was no difference regarding the incidence of post-OLT infection and rejection between the two types. No recurrence of AIH was observed. The 6-year actuarial survival rates for type I and type II patients were 76% and 43%, respectively. Type II AIH patients who have a poor response to medical therapy should be considered for OLT with a shortened delay.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Hepatitis, Autoimmune / classification*
  • Hepatitis, Autoimmune / surgery*
  • Humans
  • Liver Transplantation / methods*
  • Liver Transplantation / mortality
  • Liver Transplantation / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery
  • Recurrence
  • Reoperation
  • Survival Analysis
  • Treatment Outcome