[Posttransplant relapse in non viral hepatopathies]. / Recidiva postrasplante de hepatopatías no virales.

OBJECTIVE: We describe the recurrence of non-viral liver disease after orthotopic liver transplantation (OLT). METHODS AND RESULTS: We studied 39 patients who received an OLT for non-viral chronic liver disease. Six (15.3%) of these patients presented disease recurrence after OLT, one following alcohol abuse, 3 presented autoimmune liver disease [2 received an OLT for primary biliary cirrhosis and recurred as autoimmune hepatitis (AIH) one patient had cryptogenic cirrhosis before OLT and recurred as AIH]. One patient showed recurrence of a non-alcoholic steatohepatitis (NASH). One patient received an OLT for cirrhosis secondary to the use of metothrexate and post OLT developed secondary biliary cirrhosis due to a choledocal stenosis in the anastomotic site. CONCLUSIONS: All patients described here displayed long term recurrence (after 11 months post OLT). The recurrence of alcoholism was 8.3% among patients transplanted for this condition. AIH was observed in 30% of cases and NASH in 20%. All three patients with autoimmune liver disease recurred with a different autoimmune disease post OLT.

Recidiva postrasplante de hepatopatías no virales / Posttransplant relapse in non viral hepatopathies

Objetivo: El objetivo del presente trabajo fue analizar la frecuencia y presentación de recidiva de hepatopatías postrasplante no virales. Métodos y Resultados: Los pacientes con hepatopatías no virales que recibieron un trasplante hepático fueron 39 y de éstos, seis presentaron recidiva de la enfermedad (15.3%): uno con recaída del alcoholismo, tres con enfermedad autoinmune (dos trasplantados por cirrosis biliar primaria recurrieron con hepatitis autoinmune y uno con diagnóstico original de cirrosis hepática criptogénica presentó recurrencia de hepatitis autoinmune), uno con diagnóstico de esteatohepatitis no alcohólica tuvo recurrencia con la misma enfermedad; por último, un paciente se trasplantó por cirrosis hepática secundaria a metotrexate y postrasplante manifestó cirrosis biliar secundaria a estenosis del colédoco en el sitio de la anastomosis. Conclusiones: Todos los pacientes aquí analizados presentaron recidiva en el largo plazo (después de 11 meses postrasplante). La recidiva del alcoholismo se identificó en 8.3%, de las hepatopatías autoinmunes en 30%, y de la esteatohepatitis no alcohólica en 20% de los casos. Las tres pacientes con recidiva de hepatopatía autoinmune presentaron en el postras-plante una enfermedad diferente a la que dio origen al trasplante.

OBJECTIVE: We describe the recurrence of non-viral liver disease after orthotopic liver transplantation (OLT). METHODS AND RESULTS: We studied 39 patients who received an OLT for non-viral chronic liver disease. Six (15.3%) of these patients presented disease recurrence after OLT, one following alcohol abuse, 3 presented autoimmune liver disease [2 received an OLT for primary biliary cirrhosis and recurred as autoimmune hepatitis (AIH) one patient had cryptogenic cirrhosis before OLT and recurred as AIH]. One patient showed recurrence of a non-alcoholic steatohepatitis (NASH). One patient received an OLT for cirrhosis secondary to the use of metothrexate and post OLT developed secondary biliary cirrhosis due to a choledocal stenosis in the anastomotic site. CONCLUSIONS: All patients described here displayed long term recurrence (after 11 months post OLT). The recurrence of alcoholism was 8.3% among patients transplanted for this condition. AIH was observed in 30% of cases and NASH in 20%. All three patients with autoimmune liver disease recurred with a different autoimmune disease post OLT.