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Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation

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Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation. / Montano-Loza, Aldo J; Ronca, Vincenzo; Ebadi, Maryam; Hansen, Bettina E; Hirschfield, Gideon; Elwir, Saleh; Alsaed, Mohamad; Milkiewicz, Piotr; Janik, Maciej K; Marschall, Hanns-Ulrich; Burza, Maria Antonella; Efe, Cumali; Calışkan, Ali Rıza; Harputluoglu, Murat; Kabaçam, Gökhan; Terrabuio, Débora; de Quadros Onofrio, Fernanda; Selzner, Nazia; Bonder, Alan; Parés, Albert; Llovet, Laura; Akyıldız, Murat; Arikan, Cigdem; Manns, Michael P; Taubert, Richard; Weber, Anna-Lena; Schiano, Thomas D; Haydel, Brandy; Czubkowski, Piotr; Socha, Piotr; Ołdak, Natalia; Akamatsu, Nobuhisa; Tanaka, Atsushi; Levy, Cynthia; Martin, Eric F; Goel, Aparna; Sedki, Mai; Jankowska, Irena; Ikegami, Toru; Rodriguez, Maria; Sterneck, Martina; Weiler-Normann, Christina; Schramm, Christoph; Donato, Maria Francesca; Lohse, Ansgar; Andrade, Raul J; Patwardhan, Vilas R; van Hoek, Bart; Biewenga, Maaike; Kremer, Andreas E; Ueda, Yoshihide; Deneau, Mark; Pedersen, Mark; Mayo, Marlyn J; Floreani, Annarosa; Burra, Patrizia; Secchi, Maria Francesca; Beretta-Piccoli, Benedetta Terziroli; Sciveres, Marco; Maggiore, Giuseppe; Jafri, Syed-Mohammed; Debray, Dominique; Girard, Muriel; Lacaille, Florence; Lytvyak, Ellina; Mason, Andrew L; Heneghan, Michael; Oo, Ye Htun; International Autoimmune Hepatitis Group (IAIHG).

In: J HEPATOL, Vol. 77, No. 1, 07.2022, p. 84-97.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Montano-Loza, AJ, Ronca, V, Ebadi, M, Hansen, BE, Hirschfield, G, Elwir, S, Alsaed, M, Milkiewicz, P, Janik, MK, Marschall, H-U, Burza, MA, Efe, C, Calışkan, AR, Harputluoglu, M, Kabaçam, G, Terrabuio, D, de Quadros Onofrio, F, Selzner, N, Bonder, A, Parés, A, Llovet, L, Akyıldız, M, Arikan, C, Manns, MP, Taubert, R, Weber, A-L, Schiano, TD, Haydel, B, Czubkowski, P, Socha, P, Ołdak, N, Akamatsu, N, Tanaka, A, Levy, C, Martin, EF, Goel, A, Sedki, M, Jankowska, I, Ikegami, T, Rodriguez, M, Sterneck, M, Weiler-Normann, C, Schramm, C, Donato, MF, Lohse, A, Andrade, RJ, Patwardhan, VR, van Hoek, B, Biewenga, M, Kremer, AE, Ueda, Y, Deneau, M, Pedersen, M, Mayo, MJ, Floreani, A, Burra, P, Secchi, MF, Beretta-Piccoli, BT, Sciveres, M, Maggiore, G, Jafri, S-M, Debray, D, Girard, M, Lacaille, F, Lytvyak, E, Mason, AL, Heneghan, M, Oo, YH & International Autoimmune Hepatitis Group (IAIHG) 2022, 'Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation', J HEPATOL, vol. 77, no. 1, pp. 84-97. https://doi.org/10.1016/j.jhep.2022.01.022

APA

Montano-Loza, A. J., Ronca, V., Ebadi, M., Hansen, B. E., Hirschfield, G., Elwir, S., Alsaed, M., Milkiewicz, P., Janik, M. K., Marschall, H-U., Burza, M. A., Efe, C., Calışkan, A. R., Harputluoglu, M., Kabaçam, G., Terrabuio, D., de Quadros Onofrio, F., Selzner, N., Bonder, A., ... International Autoimmune Hepatitis Group (IAIHG) (2022). Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation. J HEPATOL, 77(1), 84-97. https://doi.org/10.1016/j.jhep.2022.01.022

Vancouver

Montano-Loza AJ, Ronca V, Ebadi M, Hansen BE, Hirschfield G, Elwir S et al. Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation. J HEPATOL. 2022 Jul;77(1):84-97. https://doi.org/10.1016/j.jhep.2022.01.022

Bibtex

@article{83bf12b39acd4991bf85ce4bb705c477,
title = "Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation",
abstract = "BACKGROUND & AIMS: Autoimmune hepatitis can recur after liver transplantation (LT), though the impact of recurrence on patient and graft survival has not been well characterized. We evaluated a large, international, multicenter cohort to identify the probability and risk factors associated with recurrent AIH and the association between recurrent disease and patient and graft survival.METHODS: We included 736 patients (77% female, mean age 42±1 years) with AIH who underwent LT from January 1987 through June 2020, among 33 centers in North America, South America, Europe and Asia. Clinical data before and after LT, biochemical data within the first 12 months after LT, and immunosuppression after LT were analyzed to identify patients at higher risk of AIH recurrence based on histological diagnosis.RESULTS: AIH recurred in 20% of patients after 5 years and 31% after 10 years. Age at LT ≤42 years (hazard ratio [HR] 3.15; 95% CI 1.22-8.16; p = 0.02), use of mycophenolate mofetil post-LT (HR 3.06; 95% CI 1.39-6.73; p = 0.005), donor and recipient sex mismatch (HR 2.57; 95% CI 1.39-4.76; p = 0.003) and high IgG pre-LT (HR 1.04; 95% CI 1.01-1.06; p = 0.004) were associated with higher risk of AIH recurrence after adjusting for other confounders. In multivariate Cox regression, recurrent AIH (as a time-dependent covariate) was significantly associated with graft loss (HR 10.79, 95% CI 5.37-21.66, p <0.001) and death (HR 2.53, 95% CI 1.48-4.33, p = 0.001).CONCLUSION: Recurrence of AIH following transplant is frequent and is associated with younger age at LT, use of mycophenolate mofetil post-LT, sex mismatch and high IgG pre-LT. We demonstrate an association between disease recurrence and impaired graft and overall survival in patients with AIH, highlighting the importance of ongoing efforts to better characterize, prevent and treat recurrent AIH.LAY SUMMARY: Recurrent autoimmune hepatitis following liver transplant is frequent and is associated with some recipient features and the type of immunosuppressive medications use. Recurrent autoimmune hepatitis negatively affects outcomes after liver transplantation. Thus, improved measures are required to prevent and treat this condition.",
author = "Montano-Loza, {Aldo J} and Vincenzo Ronca and Maryam Ebadi and Hansen, {Bettina E} and Gideon Hirschfield and Saleh Elwir and Mohamad Alsaed and Piotr Milkiewicz and Janik, {Maciej K} and Hanns-Ulrich Marschall and Burza, {Maria Antonella} and Cumali Efe and Calı{\c s}kan, {Ali Rıza} and Murat Harputluoglu and G{\"o}khan Kaba{\c c}am and D{\'e}bora Terrabuio and {de Quadros Onofrio}, Fernanda and Nazia Selzner and Alan Bonder and Albert Par{\'e}s and Laura Llovet and Murat Akyıldız and Cigdem Arikan and Manns, {Michael P} and Richard Taubert and Anna-Lena Weber and Schiano, {Thomas D} and Brandy Haydel and Piotr Czubkowski and Piotr Socha and Natalia O{\l}dak and Nobuhisa Akamatsu and Atsushi Tanaka and Cynthia Levy and Martin, {Eric F} and Aparna Goel and Mai Sedki and Irena Jankowska and Toru Ikegami and Maria Rodriguez and Martina Sterneck and Christina Weiler-Normann and Christoph Schramm and Donato, {Maria Francesca} and Ansgar Lohse and Andrade, {Raul J} and Patwardhan, {Vilas R} and {van Hoek}, Bart and Maaike Biewenga and Kremer, {Andreas E} and Yoshihide Ueda and Mark Deneau and Mark Pedersen and Mayo, {Marlyn J} and Annarosa Floreani and Patrizia Burra and Secchi, {Maria Francesca} and Beretta-Piccoli, {Benedetta Terziroli} and Marco Sciveres and Giuseppe Maggiore and Syed-Mohammed Jafri and Dominique Debray and Muriel Girard and Florence Lacaille and Ellina Lytvyak and Mason, {Andrew L} and Michael Heneghan and Oo, {Ye Htun} and {International Autoimmune Hepatitis Group (IAIHG)}",
note = "Copyright {\textcopyright} 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.",
year = "2022",
month = jul,
doi = "10.1016/j.jhep.2022.01.022",
language = "English",
volume = "77",
pages = "84--97",
journal = "J HEPATOL",
issn = "0168-8278",
publisher = "Elsevier",
number = "1",

}

RIS

TY - JOUR

T1 - Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation

AU - Montano-Loza, Aldo J

AU - Ronca, Vincenzo

AU - Ebadi, Maryam

AU - Hansen, Bettina E

AU - Hirschfield, Gideon

AU - Elwir, Saleh

AU - Alsaed, Mohamad

AU - Milkiewicz, Piotr

AU - Janik, Maciej K

AU - Marschall, Hanns-Ulrich

AU - Burza, Maria Antonella

AU - Efe, Cumali

AU - Calışkan, Ali Rıza

AU - Harputluoglu, Murat

AU - Kabaçam, Gökhan

AU - Terrabuio, Débora

AU - de Quadros Onofrio, Fernanda

AU - Selzner, Nazia

AU - Bonder, Alan

AU - Parés, Albert

AU - Llovet, Laura

AU - Akyıldız, Murat

AU - Arikan, Cigdem

AU - Manns, Michael P

AU - Taubert, Richard

AU - Weber, Anna-Lena

AU - Schiano, Thomas D

AU - Haydel, Brandy

AU - Czubkowski, Piotr

AU - Socha, Piotr

AU - Ołdak, Natalia

AU - Akamatsu, Nobuhisa

AU - Tanaka, Atsushi

AU - Levy, Cynthia

AU - Martin, Eric F

AU - Goel, Aparna

AU - Sedki, Mai

AU - Jankowska, Irena

AU - Ikegami, Toru

AU - Rodriguez, Maria

AU - Sterneck, Martina

AU - Weiler-Normann, Christina

AU - Schramm, Christoph

AU - Donato, Maria Francesca

AU - Lohse, Ansgar

AU - Andrade, Raul J

AU - Patwardhan, Vilas R

AU - van Hoek, Bart

AU - Biewenga, Maaike

AU - Kremer, Andreas E

AU - Ueda, Yoshihide

AU - Deneau, Mark

AU - Pedersen, Mark

AU - Mayo, Marlyn J

AU - Floreani, Annarosa

AU - Burra, Patrizia

AU - Secchi, Maria Francesca

AU - Beretta-Piccoli, Benedetta Terziroli

AU - Sciveres, Marco

AU - Maggiore, Giuseppe

AU - Jafri, Syed-Mohammed

AU - Debray, Dominique

AU - Girard, Muriel

AU - Lacaille, Florence

AU - Lytvyak, Ellina

AU - Mason, Andrew L

AU - Heneghan, Michael

AU - Oo, Ye Htun

AU - International Autoimmune Hepatitis Group (IAIHG)

N1 - Copyright © 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

PY - 2022/7

Y1 - 2022/7

N2 - BACKGROUND & AIMS: Autoimmune hepatitis can recur after liver transplantation (LT), though the impact of recurrence on patient and graft survival has not been well characterized. We evaluated a large, international, multicenter cohort to identify the probability and risk factors associated with recurrent AIH and the association between recurrent disease and patient and graft survival.METHODS: We included 736 patients (77% female, mean age 42±1 years) with AIH who underwent LT from January 1987 through June 2020, among 33 centers in North America, South America, Europe and Asia. Clinical data before and after LT, biochemical data within the first 12 months after LT, and immunosuppression after LT were analyzed to identify patients at higher risk of AIH recurrence based on histological diagnosis.RESULTS: AIH recurred in 20% of patients after 5 years and 31% after 10 years. Age at LT ≤42 years (hazard ratio [HR] 3.15; 95% CI 1.22-8.16; p = 0.02), use of mycophenolate mofetil post-LT (HR 3.06; 95% CI 1.39-6.73; p = 0.005), donor and recipient sex mismatch (HR 2.57; 95% CI 1.39-4.76; p = 0.003) and high IgG pre-LT (HR 1.04; 95% CI 1.01-1.06; p = 0.004) were associated with higher risk of AIH recurrence after adjusting for other confounders. In multivariate Cox regression, recurrent AIH (as a time-dependent covariate) was significantly associated with graft loss (HR 10.79, 95% CI 5.37-21.66, p <0.001) and death (HR 2.53, 95% CI 1.48-4.33, p = 0.001).CONCLUSION: Recurrence of AIH following transplant is frequent and is associated with younger age at LT, use of mycophenolate mofetil post-LT, sex mismatch and high IgG pre-LT. We demonstrate an association between disease recurrence and impaired graft and overall survival in patients with AIH, highlighting the importance of ongoing efforts to better characterize, prevent and treat recurrent AIH.LAY SUMMARY: Recurrent autoimmune hepatitis following liver transplant is frequent and is associated with some recipient features and the type of immunosuppressive medications use. Recurrent autoimmune hepatitis negatively affects outcomes after liver transplantation. Thus, improved measures are required to prevent and treat this condition.

AB - BACKGROUND & AIMS: Autoimmune hepatitis can recur after liver transplantation (LT), though the impact of recurrence on patient and graft survival has not been well characterized. We evaluated a large, international, multicenter cohort to identify the probability and risk factors associated with recurrent AIH and the association between recurrent disease and patient and graft survival.METHODS: We included 736 patients (77% female, mean age 42±1 years) with AIH who underwent LT from January 1987 through June 2020, among 33 centers in North America, South America, Europe and Asia. Clinical data before and after LT, biochemical data within the first 12 months after LT, and immunosuppression after LT were analyzed to identify patients at higher risk of AIH recurrence based on histological diagnosis.RESULTS: AIH recurred in 20% of patients after 5 years and 31% after 10 years. Age at LT ≤42 years (hazard ratio [HR] 3.15; 95% CI 1.22-8.16; p = 0.02), use of mycophenolate mofetil post-LT (HR 3.06; 95% CI 1.39-6.73; p = 0.005), donor and recipient sex mismatch (HR 2.57; 95% CI 1.39-4.76; p = 0.003) and high IgG pre-LT (HR 1.04; 95% CI 1.01-1.06; p = 0.004) were associated with higher risk of AIH recurrence after adjusting for other confounders. In multivariate Cox regression, recurrent AIH (as a time-dependent covariate) was significantly associated with graft loss (HR 10.79, 95% CI 5.37-21.66, p <0.001) and death (HR 2.53, 95% CI 1.48-4.33, p = 0.001).CONCLUSION: Recurrence of AIH following transplant is frequent and is associated with younger age at LT, use of mycophenolate mofetil post-LT, sex mismatch and high IgG pre-LT. We demonstrate an association between disease recurrence and impaired graft and overall survival in patients with AIH, highlighting the importance of ongoing efforts to better characterize, prevent and treat recurrent AIH.LAY SUMMARY: Recurrent autoimmune hepatitis following liver transplant is frequent and is associated with some recipient features and the type of immunosuppressive medications use. Recurrent autoimmune hepatitis negatively affects outcomes after liver transplantation. Thus, improved measures are required to prevent and treat this condition.

U2 - 10.1016/j.jhep.2022.01.022

DO - 10.1016/j.jhep.2022.01.022

M3 - SCORING: Journal article

C2 - 35143897

VL - 77

SP - 84

EP - 97

JO - J HEPATOL

JF - J HEPATOL

SN - 0168-8278

IS - 1

ER -