Recurrence of autoimmune hepatitis after liver transplantation

Transplantation. 1999 Jul 27;68(2):253-6. doi: 10.1097/00007890-199907270-00016.


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 following criteria were applied to diagnose recurrence: (1) positive autoantibodies in the titer> or =1:40; (2) hypertransaminasemia; (3) histological features of chronic hepatitis; (4) need of reintroduction or significant increase of steroids; and (5) lack of serum markers of viral 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 level at recurrence was 542+/-129 U/L. Three patients from this group needed regrafting. Mismatch of DR3+ recipient and DR3- donor was not more common 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 proportion of patients and some of them required regrafting. DR3+ patients are not particularly prone to develop recurrence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Antibodies, Antinuclear / blood
  • Aspartate Aminotransferases / blood
  • Biopsy
  • Female
  • Graft Rejection / diagnosis
  • Hepatitis, Autoimmune / pathology
  • Hepatitis, Autoimmune / prevention & control*
  • Hepatitis, Autoimmune / surgery*
  • Humans
  • Liver Transplantation* / adverse effects
  • Male
  • Recurrence
  • Time Factors


  • Antibodies, Antinuclear
  • Aspartate Aminotransferases