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Pearl Toh, 22 Oct 2020
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Low retransplantation rate tied to increased mortality in recurring autoimmune hepatitis

30 Jul 2020

The low rate of retransplantation in patients with recurring autoimmune hepatitis (AIH) is partly to blame for the greater post-transplant mortality in this population compared with other autoimmune liver disease, suggests a recent study.

Autoimmune liver diseases, such as primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and AIH, generally have favourable post-transplant outcomes, with prior studies showing that the risk of disease recurrence is similar in AIH and PSC. In addition, the latter is known to require more retransplantation than PBC.

The investigators compared post-transplant graft survival and the need for retransplant in AIH compared with other autoimmune liver diseases using Cox regression, as well as competing risk analyses using the United Network for Organ Sharing database.

After controlling for potential confounders, AIH was found to significantly correlate with lower graft survival than PBC (hazard ratio [HR], 0.86, 95 percent confidence interval [CI], 0.77–0.96) and PSC (HR, 0.89, 95 percent CI, 0.8–0.99), which was primarily driven by post-transplant death.

Competing risk analysis also revealed a higher risk of death with AIH compared with PBC (subdistribution HR, 0.79, 95 percent CI, 0.7–0.89) and PSC (subdistribution HR, 0.72, 95 percent CI, 0.64–0.82). In addition, AIH was associated with a lower risk of retransplant than PSC (subdistribution HR, 1.48, 95 percent CI, 1.19–1.8).

A recent population-based prospective study found a significantly higher incidence of AIH from 2014–2016 than 2008–2010, while incidences of PBC and PSC remained the same over the same period. [Clin Gastroenterol Hepatol 2020;doi:10.1016/j.cgh.2020.05.061]

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Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
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3 days ago
Weight suppression appears to result in future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviours, suggesting weight-suppressed women represent an at-risk group that may benefit from selective prevention programmes, a study has found.
Pearl Toh, 2 days ago
Quadrivalent human papillomavirus (HPV) vaccination can substantially reduce the risk of invasive cervical cancer, by up to almost 90 percent in women who were vaccinated early, a large Swedish registry-based study has shown.