Chronic hepatitis in pediatric liver transplan...( common abnormality (22 percent at 1 ye...),Health

common abnormality (22 percent at 1 year, 43 percent at 5 years, 64 percent at 10 years). While liver function tests at 5 years were not significantly different in children who had CH, the presence of autoantibodies was significantly higher at 5 and 10 years in children with CH (72 percent and 80 percent respectively). In addition, there was a strong association between the presence of CH and the development of progressive fibrosis (the formation of scar-like tissue). The authors note that "the finding of increasing fibrosis in children with chronic hepatitis has not been reported before and has potentially important implications for long term graft function."

The authors note that transient autoantibody production following transplant sometimes occurs during episodes of rejection. In addition, late rejection may be associated with tissue changes that are different to those normally seen in acute rejection but more closely resemble those seen in chronic viral or autoimmune hepatitis. "It is therefore possible that some cases of otherwise unexplained chronic hepatitis in the liver allograft may represent a form of late cellular rejection," the authors suggest.

The results of the present study indicate that important tissue abnormalities can be detected in biopsies obtained from children who are clinically well and have normal liver function tests, the authors state. "Screening for chronic allograft hepatitis using liver biochemistry is therefore not possible and may instead require regular measurement of autoantibodies," they conclude.

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Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
2-May-2006

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