title: First-Degree Living-Related Donor Liver Transplantation in Autoimmune Liver Diseases.
abstract: Liver transplantation (LT) is the treatment of choice for end-stage autoimmune liver diseases. However, the underlying disease may recur in the graft in some 20% of cases. The aim of this study is to determine whether LT using living donor grafts from first-degree relatives results in higher rates of recurrence than grafts from more distant/unrelated donors. Two hundred sixty-three patients, who underwent a first LT in the Toronto liver transplant program between January 2000 and March 2015 for autoimmune liver diseases, and had at least 6 months of post-LT follow-up, were included in this study. Of these, 72 (27%) received a graft from a first-degree living-related donor, 56 (21%) from a distant/unrelated living donor, and 135 (51%) from a deceased donor for primary sclerosing cholangitis (PSC) (n = 138, 52%), primary biliary cholangitis (PBC) (n = 69, 26%), autoimmune hepatitis (AIH) (n = 44, 17%), and overlap syndromes (n = 12, 5%). Recurrence occurred in 52 (20%) patients. Recurrence rates for each autoimmune liver disease were not significantly different after first-degree living-related, living-unrelated, or deceased-donor LT. Similarly, time to recurrence, recurrence-related graft failure, graft survival, and patient survival were not significantly different between groups. In conclusion, first-degree living-related donor LT for PSC, PBC, or AIH is not associated with an increased risk of disease recurrence.
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: A D
authors.initials: AD
authors.lastname: Aravinthan
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: A C
authors.initials: AC
authors.lastname: Doyle
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Issachar
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Dib
authors.affiliation: Manitoba Liver Transplant Program, University of Manitoba, Winnipeg, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Peretz
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: M S
authors.initials: MS
authors.lastname: Cattral
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Ghanekar
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: I D
authors.initials: ID
authors.lastname: McGilvray
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Selzner
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: P D
authors.initials: PD
authors.lastname: Greig
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: D R
authors.identifier: 0000-0003-4468-8276
authors.initials: DR
authors.lastname: Grant
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Selzner
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: L B
authors.initials: LB
authors.lastname: Lilly
authors.affiliation: Multiorgan Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Canada.
authors.forename: E L
authors.initials: EL
authors.lastname: Renner
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000601:surgery*; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors
keywords: clinical research/practice; health services and outcomes research; liver disease, liver transplantation: living donor; liver transplantation/hepatology