Risk factors for autoimmune liver disease recurrence after liver transplantation
Journal
World Journal of Transplantation
ISSN
2220-3230
Publisher
Baishideng Publishing Group Inc.
Date Issued
2025
Author(s)
Salgado-de la Mora, Moisés
Mendez-Guerrero, Osvely
Torre, Aldo
Vilatoba, Mario
Castro Narro, Graciela E
Navarro-Alvarez, Nalu
Type
text::journal::journal article
Abstract
Background: Autoimmune liver disease (AILD) recurrence is common after liver transplantation (LT). While several risk factors for recurrence have been identified, their combined predictive value has yet to be thoroughly investigated. Aim: To evaluate the combined predictive value of clinical and laboratory risk factors for AILD recurrence after LT. Methods: This retrospective cohort study included 79 patients with AILD who underwent LT at a single liver transplant center. We compared clinical and laboratory variables between patients with and without recurrent disease and assessed the predictive performance of these factors using four logistic regression models and their corresponding area under the receiver operating characteristic curve (AUC). Results: Recurrent AILD occurred in 26.58% of patients (95%CI: 17-38), the median time to recurrence was 28 months (interquartile range: 16-38). Patients with recurrent AILD had significantly higher pre-transplant Child-Pugh scores [11.61 ± 1.16 vs 10.58 ± 1.96 points; odds ratio (OR) = 1.43, 95%CI: 1.03-2.00; P = 0.032] and model for end-stage liver disease score (MELD) (22.76 ± 5.47 vs 18.81 ± 7.24 points; OR = 1.08, 95%CI: 1.01-1.16; P = 0.032), compared to those without recurrence. Additionally, baseline alanine aminotransferase (ALT) > 2 times the upper limit of normal (ULN) was significantly associated with recurrence (31% vs 57.1%; OR = 2.96, 95%CI: 1.06-8.28; P = 0.038). Our models, incorporating several risk variables, demonstrated moderate predictive ability for AILD recurrence. The AUCs were as follows: (1) Model 1 (AUC = 0.75, 95%CI: 0.58-0.87); (2) Model 2 (AUC = 0.74, 95%CI: 0.59-0.90); (3) Model 3 (AUC = 0.72, 95%CI: 0.58-0.88); and (4) Model 4 (AUC = 0.63, 95%CI: 0.40-0.76), with no statistically significant difference between the models (P = 0.488). Conclusion: Higher pre-transplant Child-Pugh and MELD scores, as well as ALT > 2 ULN, were associated with an increased risk of AILD recurrence. ©The authors ©Baishideng Publishing Group Inc.
License
Acceso Abierto
How to cite
Salgado-de la Mora, M., Mendez-Guerrero, O., Torre, A., Vilatoba, M., Castro Narro, G. E., Lumbreras Márquez, M. I., & Navarro-Alvarez, N. (2025). Risk factors for autoimmune liver disease recurrence after liver transplantation. World Journal of Transplantation, 15(4). https://doi.org/10.5500/wjt.v15.i4.106938