title: Adult and pediatric liver transplantation for autoimmune hepatitis.
abstract: BACKGROUND
  Due to the early age that pediatric patients with autoimmune hepatitis (AIH) are transplanted, it is theorized that older AIH patients may have different outcomes than pediatric patients following liver transplantation.
  
  
  METHODS
  This is a retrospective review of both the adult and pediatric liver transplant programs consisting of 56 patients. Rejection and recurrence of AIH were determined by biopsy.
  
  
  RESULTS
  The autoimmune patient having rejection episodes had a 1.76-fold increase in relative risk to develop autoimmune recurrence when compared to patients without rejection [RR = 1.76; 95% CIRR (1.08, 2.86)]. The pediatric group had a 6.62-fold increase in relative risk to develop colitis following liver transplantation [RR = 6.62; 95% C.I.R.R. (1.36, 32.13); P =.02]. Mean days to recurrence of AIH were similar in both groups (1364 +/- 1074 vs 936; P = NS). There were more hospitalized days in the pediatric group compared to the adults (20.5 +/- 13.3 days vs 51.7 +/- 22.2 days, P =.039). OKT-3 was rarely used (n = 5) in either group (9.3% vs 7.7%, P = NS) and was not correlated with which patients would be weaned from steroids or recurrence.
  
  
  CONCLUSIONS
  Based on this review, pediatric patients were more likely to develop ulcerative colitis following liver transplantation and they incurred longer hospital stays than adults. The adult group was more likely to be weaned from steroids, with AIH recurrence unrelated to weaning.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: T G
authors.initials: TG
authors.lastname: Heffron
authors.forename: G A
authors.initials: GA
authors.lastname: Smallwood
authors.forename: B
authors.initials: B
authors.lastname: Oakley
authors.forename: T
authors.initials: T
authors.lastname: Pillen
authors.forename: D
authors.initials: D
authors.lastname: Welch
authors.forename: K
authors.initials: K
authors.lastname: Connor
authors.forename: E
authors.initials: E
authors.lastname: Martinez
authors.forename: R
authors.initials: R
authors.lastname: Romero
authors.forename: A C
authors.initials: AC
authors.lastname: Stieber
mesh_terms: D000328:Adult; D002648:Child; D003092:Colitis / Q000453:epidemiology; D005260:Female; D019693:Hepatitis, Autoimmune / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome