First-Degree Living-Related Donor Liver Transplantation in Autoimmune Liver Dise

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http://onlinelibrary.wiley.com/doi/10.1111/ajt.13828/abstract?wol1URL=/doi/10.1111/ajt.13828/abstract&campaign=woletoc&regionCode=US-MA&identityKey=a5109188-bc4b-4411-a341-f25d0601fa74

First-Degree Living-Related Donor Liver Transplantation in Autoimmune Liver Diseases
Authors
      A. D. Aravinthan, et al.,
      First published: 23 May 2016
      DOI: 10.1111/ajt.13828
Abstract
Liver transplantation (LT) is the treatment of choice for end-stage autoimmune liver diseases. However, the underlying disease may recur in the graft in some 20% of cases. The aim of this study is to determine whether LT using living donor grafts from first-degree relatives results in higher rates of recurrence than grafts from more distant/unrelated donors. Two hundred sixty-three patients, who underwent a first LT in the Toronto liver transplant program between January 2000 and March 2015 for autoimmune liver diseases, and had at least 6 months of post-LT follow-up, were included in this study. Of these, 72 (27%) received a graft from a first-degree living-related donor, 56 (21%) from a distant/unrelated living donor, and 135 (51%) from a deceased donor for primary sclerosing cholangitis (PSC) (n = 138, 52%), primary biliary cholangitis (PBC) (n = 69, 26%), autoimmune hepatitis (AIH) (n = 44, 17%), and overlap syndromes (n = 12, 5%). Recurrence occurred in 52 (20%) patients. Recurrence rates for each autoimmune liver disease were not significantly different after first-degree living-related, living-unrelated, or deceased-donor LT. Similarly, time to recurrence, recurrence-related graft failure, graft survival, and patient survival were not significantly different between groups. In conclusion, first-degree living-related donor LT for PSC, PBC, or AIH is not associated with an increased risk of disease recurrence.