Long‐term outcome of liver transplantation for autoimmune hepatitis: A French nationwide study over 30 years - Institut de Recherche en Santé, Environnement et Travail Access content directly
Journal Articles Liver International Year : 2023

Long‐term outcome of liver transplantation for autoimmune hepatitis: A French nationwide study over 30 years

Yasmina Chouik
Claire Francoz
Armand Abergel
Mario Altieri
  • Function : Author
Louise Barbier
  • Function : Author
Camille Besch
  • Function : Author
Christophe Duvoux
Georges‐philippe Pageaux
Sylvie Radenne
Jérôme Dumortier

Abstract

Background & aims: Autoimmune hepatitis (AIH) is a rare indication for liver transplantation (LT). The aims of this study were to evaluate long-term survival after LT for AIH and prognostic factors, especially the impact of recurrent AIH (rAIH). Methods: A multicentre retrospective nationwide study including all patients aged ≥16 transplanted for AIH in Fr Results: The study population consisted of 301 patients transplanted from 1987 to 2018. Median age at LT was 43 years (IQR, 29.4-53.8). Median follow-up was 87.0 months (IQR, 43.5-168.0). Seventy-four patients (24.6%) developed rAIH. Graft survival was 91%, 79%, 65% at 1, 10 and 20 years respectively. Patient survival was 94%, 84% and 74% at 1, 10 and 20 years respectively. From multivariate Cox regression, factors significantly associated with poorer patient survival were patient age ≥58 years (HR = 2.9; 95% CI, 1.4-6.2; p = 0.005) and occurrence of an infectious episode within the first year after LT (HR = 2.5; 95% CI, 1.2-5.1; p = 0.018). Risk factors for impaired graft survival were: occurrence of rAIH (HR = 2.7; 95% CI, 1.5-5.0; p = 0.001), chronic rejection (HR = 2.9; 95% CI, 1.4-6.1; p = 0.005), biliary (HR = 2.0; 95% CI, 1.2-3.4; p = 0.009), vascular (HR = 1.8; 95% CI, 1.0-3.1; p = 0.044) and early septic (HR = 2.1; 95% CI, 1.2-3.5; p = 0.006) complications. Conclusion: Our results confirm that survival after LT for AIH is excellent. Disease recurrence and chronic rejection reduce graft survival. The occurrence of an infectious complication during the first year post-LT identifies at-risk patients for graft loss and death.
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hal-04150813 , version 1 (30-05-2024)

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Yasmina Chouik, Olivier Chazouillères, Claire Francoz, Eleonora de Martin, Olivier Guillaud, et al.. Long‐term outcome of liver transplantation for autoimmune hepatitis: A French nationwide study over 30 years. Liver International, 2023, 43 (5), pp.1068-1079. ⟨10.1111/liv.15552⟩. ⟨hal-04150813⟩
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