1. HLA-DR Mismatch and Black Race Are Associated With Recurrent Autoimmune Hepatitis After Liver Transplantation
- Author
-
Marshall McCabe, IV, MD, Natalia Rush, MD, Craig Lammert, MD, Kavish R. Patidar, MD, Lauren Nephew, MD, Romil Saxena, MD, Burcin Ekser, MD, James Salven, MS, Chandrashekhar Kubal, MD, PhD, and Marwan Ghabril, MD
- Subjects
Surgery ,RD1-811 - Abstract
Background. The predictors of recurrent autoimmune hepatitis (R-AIH) after liver transplantation (LT) are heterogeneous with limited data to guide immunosuppression, with little data on impact of race. Aims. To describe the incidence, predictors, and outcomes of R-AIH. Methods. We studied patients undergoing LT for AIH during 2000–2017 at our center. Liver biopsies were performed for clinical indications. R-AIH was defined using clinical and histologic criteria. Results. Among 75 patients undergoing LT for AIH (mean age 45 ± 16, 65% female individuals, 19% Black), 71 (95%) received antithymocyte globulin induction with tacrolimus-based immunosuppression. R-AIH developed in 20 (27%) patients at a median interval of 313 d (interquartile range, 155–1205). R-AIH was associated with level 2 HLA-DR mismatch (hazard ratio, 3.6; (95% confidence interval, 1.3-9.9; P = 0.01) and Black race (hazard ratio, 4.5; 95% confidence interval, 1.8-11.8; P = 0.002)] in the multivariable analysis. R-AIH developed in 62% of patients with level 2 HLA-DR mismatch on single-agent immunosuppression but in
- Published
- 2021
- Full Text
- View/download PDF