Chen Ching-Yi, Ho Ming-Chih, Wu Jia-Feng, Jeng Yung-Ming, Chen Huey-Ling, Chang Mei-Hwei, Lee Po-Huang, Hu Rey-Heng, Ni Yen-Hsuan
Department of Pediatrics, College of Medicine and Children's Hospital, Taipei, Taiwan.
Pediatr Transplant. 2013 Mar;17(2):144-8. doi: 10.1111/petr.12032. Epub 2012 Dec 6.
Dn-AIH is a long-term complication after LT. The aim of this study was to analyze the occurrence of autoantibodies in pediatric recipients and the clinical significance. From 1992 to 2008, 96 pediatric LT for non-autoimmune liver diseases were performed in 94 children in our institution. Serum autoantibodies were checked in 68 subjects (73.9%). A positive autoantibody was defined as titers ≥1:40 for ANA, or ≥1:20 for ASMA, anti-LKM, and AMA. Autoantibodies were detectable in 51 of 68 patients (75.0%). There was positivity for ANA in 30 patients, ASMA in 32, and AMA in three, while anti-LKM was all negative. Immunosuppressive treatment with CsA, more than one episode of rejection, and abnormal ALT were risk factors for the development of autoantibodies. The incidence of the development of autoantibodies was 75.0% in pediatric LT cases in this study. ASMA was the most commonly found autoantibody. Autoantibodies may not play a sentinel role for dn-AIH after LT.
供肝移植后迟发性自身免疫性肝炎（Dn - AIH）是一种长期并发症。本研究旨在分析小儿受者自身抗体的发生情况及其临床意义。1992年至2008年，我们机构对94名儿童进行了96例非自身免疫性肝病的小儿肝移植手术。对68名受试者（73.9%）检测了血清自身抗体。自身抗体阳性定义为抗核抗体（ANA）滴度≥1:40，或抗平滑肌抗体（ASMA）、抗肝肾微粒体抗体（anti - LKM）和抗线粒体抗体（AMA）滴度≥1:20。68例患者中有51例（75.0%）可检测到自身抗体。30例患者ANA阳性，32例ASMA阳性，3例AMA阳性，而anti - LKM均为阴性。使用环孢素A（CsA）进行免疫抑制治疗、多次发生排斥反应以及丙氨酸转氨酶（ALT）异常是自身抗体产生的危险因素。本研究中小儿肝移植病例中自身抗体产生的发生率为75.0%。ASMA是最常见的自身抗体。肝移植后自身抗体可能对Dn - AIH不具有警示作用。
