Liver Graft Dysfunction May Be from Autoimmune Hepatitis

Diagnosis should be considered along with rejection in patients with hepatitis C

MONDAY, Feb. 26 (HealthDay News) -- Patients infected with hepatitis C virus who develop graft dysfunction after liver transplantation and antiviral treatment may have autoimmune hepatitis rather than organ rejection, according to study findings published in the February issue of Gut.

Pietro Andreone, M.D., and colleagues from the Universita di Bologna in Italy describe the cases of nine out of 44 patients who developed graft dysfunction after liver transplantation, which had been followed by treatment with pegylated-interferon alpha-2b and ribavirin for at least six months for hepatitis C virus infection.

For all patients, the International Autoimmune Hepatitis score suggested "probable autoimmune hepatitis" (score 10-14) rather than rejection, according to the researchers, who excluded pre-existing autoimmune hepatitis. Three patients were determined to have other autoimmune disorders, such as systemic lupus erythematosus. The presence of anti-lymphocyte antibodies significantly correlated with the development of autoimmune hepatitis, while treatment with granulocyte colony-stimulating factor was protective.

"De novo autoimmune hepatitis should be considered in differential diagnosis along with rejection in liver transplanted patients developing graft dysfunction while on treatment with interferon," Andreone and colleagues conclude.

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