Increased Posttransplant Mortality for Autoimmune Hepatitis Compared With Other Autoimmune Liver Diseases.
J Clin Gastroenterol
; 54(7): 648-654, 2020 08.
Article
em En
| MEDLINE
| ID: mdl-31651572
ABSTRACT
GOALS We sought to compare posttransplant outcomes between autoimmune liver disease. BACKGROUND:
Autoimmune liver diseases, namely primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and autoimmune hepatitis (AIH) generally have favorable posttransplant outcomes. PSC is known to require more retransplantation compared with PBC, however, comparisons to AIH are lacking. We sought to compare graft survival and the need for retransplant in AIH compared with other autoimmune liver disease. STUDY We compared posttransplant graft survival among the 3 entities using Cox regression and competing for risk analyses using the United Network for Organ Sharing (UNOS) database.RESULTS:
We found AIH is associated with significantly decreased graft survival compared with PBC [hazard ratio 0.86; 95% confidence interval (CI) 0.77-0.96] and PSC (hazard ratio 0.89; 95% CI 0.8-0.99) after controlling for potential confounders. This is mainly driven by posttransplant death. On competing for risk analysis, AIH was associated with higher risk of death compared with PBC [subdistribution hazard ratio (SHR) 0.79; 95% CI 0.7-0.89] and PSC (SHR 0.72; 95% CI 0.64-0.82) and lower risk of retransplant compared with PSC (SHR 1.48; 95% CI 1.19-1.8).CONCLUSION:
As prior studies have shown the similar risk of disease recurrence in AIH and PSC, our study indicates at least part of the increased posttransplant mortality in AIH may be due lower retransplantation rate in this population.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças Autoimunes
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Colangite Esclerosante
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Hepatite Autoimune
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Cirrose Hepática Biliar
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Hepatopatias
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article