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Copyright ©2008 The WJG Press and Baishideng.
World J Gastroenterol. Jun 7, 2008; 14(21): 3388-3395
Published online Jun 7, 2008. doi: 10.3748/wjg.14.3388
Table 1 Criteria for the diagnosis of recurrent AIH
Liver transplant for autoimmune hepatitis
Auto-antibodies in significant titre (> 1:40)
Sustained rise in serum aminotransferase activity (> 2 times normal)
Elevated serum immunoglobulins
Compatible liver histology (infiltration of portal tracts by plasma cells, piecemeal necrosis and bridging necrosis[21])
Corticosteroid dependency
Exclusion of other causes of graft dysfunction (such as rejection and HCV infection)
Table 2 Reports of recurrent autoimmune hepatitis
AuthorFollow up (mo)nRecurrencePeriod recurrence occurredRe-OLT/Cirrhosis
Milkiewicz 1999[23]294713/4729 mo3/47
Ayata 2000[24]67125/1235-280 d2/12
Reich 2000[15]27246/12At 15 mo3/24
Molmenti 2002[18]295511/55At end
Duclos-Vallee2003[25]120177/172.5 yr12/17
Núñez-Martínez 2003[26]38151/15At end
Vogel 2004[27]24289/285 yr4/28
Gautam 2006[21]23%2.4 mo2
Table 3 Indications for transplantation in PBC
Symptom based
Intractable pruritus refractory to medical therapy
Hepatic encephalopathy
End-stage liver disease
Recurrent variceal haemorrhage
Episode of spontaneous bacterial peritonitis
Pulmonary hypertension
Hepato-pulmonary syndrome
Diuretic resistant ascites
Progressive osteopaenia
Hepatoma (Milan criteria)
Serum bilirubin > 150 &mgr;mol/L
Serum albumin < 25 g/L
Table 4 Criteria for the diagnosis of recurrent PBC
Transplantation for PBC
Characteristic histological features of PBC
Mononuclear inflammatory infiltrates
Lymphoid aggregates
Epithelioid granulomas
Bile duct damage
Persistence of anti-mitochondrial antibodies
Elevated immunoglobulins
Exclusion of other causes of graft damage
Table 5 Criteria for the diagnosis of recurrent primary sclerosing cholangitis[72]
Transplant for PSC
Multiple non-anastomotic strictures, headings and irregularity more than 90 d post OLT
Characteristic liver histology (fibrous cholangitis and/or fibro-obliterative lesions) with or without ductopenia, biliary fibrosis or biliary cirrhosis may be seen (but absence of characteristic features does not exclude the diagnosis).
Exclusion of other causes of secondary sclerosing cholangitis & stricturing (due to surgery, trauma, ischaemia, hepatic artery stenosis/thrombosis, established ductopaenic rejection, blood type ABO incompatibility and infections)
Cholestatic liver tests