title: Liver transplantation for autoimmune hepatitis in Peru: outcomes and recurrence.
abstract: BACKGROUND
  Liver transplantation is the only therapy for end-stage liver disease. Cirrhosis secondary to autoimmune hepatitis (AIH) is an indication in 4-6% of adult transplants.
  
  
  OBJECTIVE
  To describe the outcomes and recurrence of AIH in liver transplant patients.
  
  
  METHODS
  Twenty patients were retrospectively studied.
  
  
  RESULTS
  The female/male ratio was 3:1, the median age was 36.7 years (range, 16 to 39 years), and the median MELD score was 18.5. According to serological analysis, 19 patients were AIH type 1 and one patient was AIH type 2. AIH was associated with human leukocyte antigen (HLA) DR13+ and DR4+. The overall 5-year patient and graft survival rates were 94 and 85%, respectively. Three (15.7%) cases of recurrent AIH were diagnosed based on histological evidence. Clinical and histological features of acute and chronic rejection were present in four (20%) and three (16.6%) patients, respectively.
  
  
  CONCLUSIONS
  AIH frequently affected young women, was the most frequent indication for liver transplantation. Rejection and recurrence were commonly associated with AIH, but did not affect patient survival. No significant relationship between HLA-DR type and recurrence was found. Rapid progression to cirrhosis should be considered in severe recurrences.
authors.affiliation: Transplant Department, Guillermo Almenara I. National Hospital, ESSALUD, Lima, Peru. pedro.padilla@essalud.gob.pe
authors.forename: Martín
authors.initials: M
authors.lastname: Padilla
authors.forename: Rosario
authors.initials: R
authors.lastname: Mayorga
authors.forename: Félix
authors.initials: F
authors.lastname: Carrasco
authors.forename: Tayana
authors.initials: T
authors.lastname: Bedregal
authors.forename: Fernando
authors.initials: F
authors.lastname: Bobadilla
authors.forename: Carlos
authors.initials: C
authors.lastname: Rondón
authors.forename: José
authors.initials: J
authors.lastname: Chaman
mesh_terms: D000293:Adolescent; D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D059810:HLA-DR Serological Subtypes / Q000276:immunology*; D015804:HLA-DR4 Antigen / Q000276:immunology*; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000276:immunology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010568:Peru; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D059810:HLA-DR Serological Subtypes; D015804:HLA-DR4 Antigen