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Disease recurrence after living liver transplantation for primary biliary cirrhosis: A clinical and histological follow‐up study
Author(s) -
Hashimoto Etsuko,
Shimada Masahiko,
Noguchi Sanshirou,
Taniai Makiko,
Tokushige Katsutoshi,
Hayashi Naoaki,
Takasaki Ken,
Fuchinoue Syouhei,
Ludwig Jurgen
Publication year - 2001
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2001.25357
Subject(s) - medicine , primary biliary cirrhosis , liver transplantation , gastroenterology , autoantibody , cirrhosis , transplantation , liver disease , disease , antibody , titer , immunology
We describe the recurrence of primary biliary cirrhosis (PBC) in recipients of living liver transplants. We are not aware of similar previous reports. Because most donors for living liver transplantation (LLT) are blood relatives with close HLA matches, the recurrence of PBC in transplant recipients might offer additional insights in the pathogenesis of the condition. We studied 6 women (age, 29 to 61 years) with PBC who survived LLT for at least 1 year. Tests for antimitochondrial autoantibody (AMA), antipyruvate dehydrogenase complex‐E2, immunoglobulin G (IgG) anti‐M2, and IgM anti‐M2 had confirmed the diagnosis. Donors were blood relatives in 5 instances, and one donor who was not a blood relative still had multiple HLA matches with the recipient. After LLT, we observed a decrease in AMA titers, but within 1 year, these titers increased again in 5 of the 6 patients to pre‐LLT levels or greater. Immunoblotting analysis of the anti‐M2 protein profile failed to show loss of bands and showed new bands in 3 of 6 patients. Histologically, strong evidence of recurrent PBC was found in 2 patients, and findings compatible with PBC were present in 1 additional patient. All 6 patients are doing well, without symptoms of recurrent PBC (median time post‐LLT, 35.5 months; range, 12 to 50 months).