Clinical relevance of autoantibodies after pediatric liver transplantation.
BACKGROUND
The presence of autoantibodies and development of autoimmune hepatitis after liver transplantation has recently been reported as one of the causes for chronic graft dysfunction. The pathogenesis and clinical significance of this disease still remains unclear.


METHODS
We evaluate 96 patients for the prevalence of autoantibodies and autoimmune hepatitis after pediatric liver transplantation and review their clinical follow-up including virus serologies, ultrasound examination and liver biopsies.


RESULTS
Positive autoantibodies were detected in 74% of the patients after pediatric OLT. Graft dysfunction was observed in 46% of these children, and in 35% of the transplant recipients seronegative for autoantibodies. None of the patients showed histological signs or fulfilled clinical criteria for de novo autoimmune hepatitis. One child with negative autoantibodies was diagnosed to have a histologically proven de novo AIH two yr following OLT.


CONCLUSIONS
There is a high prevalence of autoantibodies after pediatric OLT, but the incidence of de novo AIH is very rare. In transplant recipients showing elevated liver function tests de novo autoimmune hepatitis has to be excluded by liver biopsy even if the patient is seronegative for autoantibodies.
Richter
Andrea
A
Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Pediatric Gastroenterology and Hepatology, Hamburg, Germany. a.richter@uke.uni-hamburg.de
Grabhorn
Enke
E
Helmke
Knut
K
Manns
Michael P
MP
Ganschow
Rainer
R
Burdelski
Martin
M
D000293:Adolescent; D001323:Autoantibodies / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000276:immunology; D006801:Humans; D007223:Infant; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000276:immunology*; D011446:Prospective Studies
D001323:Autoantibodies