Experience of a liver transplant center in medellín, Colombia with liver transplantation for autoimmune hepatitis and characteristics associated with post-transplant recurrence

Abstract

Introduction: The recurrence of post-transplant autoimmune hepatitis implies risk of cirrhosis and graft loss. Risk factors have been proposed for recurrence, of which few data are known in Latin American patients. Objectives: To describe the characteristics of patients with liver transplantation for autoimmune hepatitis and to evaluate those associated with their recurrence during post-transplant. Methods: Historical cohort included patients with autoimmune hepatitis diagnosed after the age of 16 years and who were taken to liver transplant in a university hospital in Medellin, Colombia between January 2010 and September 2017. Collection of information from the registers of clinical history. Results: 25 patients were included. Recurrence was diagnosed in 24%. Median follow-up was 59.5 months and recurrence 32.5 months (range 11-123 months). 100% of the recurrence group were women and none of these were transplanted due to acute liver failure. There were no differences in the pre-transplant and treatment characteristics, although a higher biochemical and histological inflammatory activity was found pre-transplant in the recurrence group. Of the group with recurrence, 100% received long-term glucocor-ticoids and 33.3% had graft loss related to recurrence requiring retransplantation (p = 0.008). Conclusion: The recurrence of autoimmune hepatitis after liver transplantation in our patients is similar to that reported worldwide, is a cause of graft dysfunction to be taken into account especially after the first year post-transplant, it predominates in women. 33.3% of patients require hepatic retransplantation due to graft dysfunction.