title: De novo autoimmune hepatitis in liver transplant: State-of-the-art review.
abstract: In the two past decades, a number of communications, case-control studies, and retrospective reports have appeared in the literature with concerns about the development of a complex set of clinical, laboratory and histological characteristics of a liver graft dysfunction that is compatible with autoimmune hepatitis. The de novo prefix was added to distinguish this entity from a pre-transplant primary autoimmune hepatitis, but the globally accepted criteria for the diagnosis of autoimmune hepatitis have been adopted in the diagnostic algorithm. Indeed, de novo autoimmune hepatitis is characterized by the typical liver necro-inflammation that is rich in plasma cells, the presence of interface hepatitis and the consequent laboratory findings of elevations in liver enzymes, increases in serum gamma globulin and the appearance of non-organ specific auto-antibodies. Still, the overall features of de novo autoimmune hepatitis appear not to be attributable to a univocal patho-physiological pathway because they can develop in the patients who have undergone liver transplantation due to different etiologies. Specifically, in subjects with hepatitis C virus recurrence, an interferon-containing antiviral treatment has been indicated as a potential inception of immune system derangement. Herein, we attempt to review the currently available knowledge about de novo liver autoimmunity and its clinical management.
authors.affiliation: Ranka Vukotic, Giovanni Vitale, Luigi Muratori, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Policlinico Sant'Orsola-Malpighi, 40138 Bologna, Italy.
authors.forename: Ranka
authors.initials: R
authors.lastname: Vukotic
authors.affiliation: Ranka Vukotic, Giovanni Vitale, Luigi Muratori, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Policlinico Sant'Orsola-Malpighi, 40138 Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vitale
authors.affiliation: Ranka Vukotic, Giovanni Vitale, Luigi Muratori, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Policlinico Sant'Orsola-Malpighi, 40138 Bologna, Italy.
authors.forename: Antonia
authors.initials: A
authors.lastname: D'Errico-Grigioni
authors.affiliation: Ranka Vukotic, Giovanni Vitale, Luigi Muratori, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Policlinico Sant'Orsola-Malpighi, 40138 Bologna, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Muratori
authors.affiliation: Ranka Vukotic, Giovanni Vitale, Luigi Muratori, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Policlinico Sant'Orsola-Malpighi, 40138 Bologna, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Andreone
mesh_terms: D000818:Animals; D015551:Autoimmunity; D003937:Diagnosis, Differential; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents
keywords: Antiviral therapy; Autoimmunity; De novo autoimmune hepatitis; Differential diagnosis; Hepatitis C virus recurrence; Liver transplant; Plasma-cell hepatitis