{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T13:11:19Z","timestamp":1790428279349,"version":"4.1.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2018,8,24]],"date-time":"2018-08-24T00:00:00Z","timestamp":1535068800000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:p>Autoimmune liver diseases (AILDs) can recur following liver transplantation (LT) despite immunosuppressive therapy, with implications for graft survival. Although the evidence is not robust, disease recurrence seems to occur in the presence of less intense and\/or steroid\u2010free immunosuppression (IS) in particular in the case of autoimmune hepatitis (AIH). The main risk factor for AIH recurrence is the severity of disease activity in the explant and potential donor\/recipient human leukocyte antigen D\u2010related 3 (DR3) mismatch. The treatment for AIH recurrence includes reintroduction or increase in the dose of steroids with or without the addition of azathioprine. T cell\u2013mediated rejection episodes are also more common in AILD. Steroid withdrawal is the common practice in LT for non\u2010AILD, eliminating the risks associated with longterm exposure to steroids. In AILD, maintenance of steroids at a low dose in the long term may reduce the risk of disease recurrence and rejection. This strategy is safe when there is vigilance for steroid\u2010related adverse effects. Alternatively, identifying patients who are at the greatest risk for disease recurrence and who would benefit from intensified IS might be an option.<\/jats:p>","DOI":"10.1002\/lt.25205","type":"journal-article","created":{"date-parts":[[2018,6,12]],"date-time":"2018-06-12T07:31:34Z","timestamp":1528788694000},"page":"1113-1118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Con: Steroids Should Not Be Withdrawn in Transplant Recipients With Autoimmune Hepatitis"],"prefix":"10.1097","volume":"24","author":[{"given":"Eleni","family":"Theocharidou","sequence":"first","affiliation":[{"name":"Institute of Liver Studies,King\u2019s College Hospital National Health Service Foundation Trust,London,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Heneghan","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies,King\u2019s College Hospital National Health Service Foundation Trust,London,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,8,24]]},"reference":[{"issue":"suppl 1","key":"lt25205-bib-0001-20240115","first-page":"S48","article-title":"Early steroid withdrawal in liver transplantation is safe and beneficial","volume":"5","year":"1999","journal-title":"Liver Transpl Surg"},{"key":"lt25205-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1111\/j.1600-6143.2007.01804.x","article-title":"Tacrolimus monotherapy without steroids after liver transplantation\u2013a prospective randomized double\u2010blinded placebo\u2010controlled trial","volume":"7","year":"2007","journal-title":"Am J Transplant"},{"key":"lt25205-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"2248","DOI":"10.1007\/s10620-012-2179-3","article-title":"Diagnosis, pathogenesis, and treatment of autoimmune hepatitis after liver transplantation","volume":"57","year":"2012","journal-title":"Dig Dis Sci"},{"key":"lt25205-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jaut.2015.08.017","article-title":"\u2018De novo\u2019 and \u2018recurrent\u2019 autoimmune hepatitis after liver transplantation: a comprehensive review","volume":"66","year":"2016","journal-title":"J Autoimmun"},{"key":"lt25205-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1002\/lt.20910","article-title":"Recurrence of autoimmune liver disease after liver transplantation: a systematic review","volume":"12","year":"2006","journal-title":"Liver Transpl"},{"key":"lt25205-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1002\/lt.21796","article-title":"Risk factors for recurrence of autoimmune hepatitis after liver transplantation","volume":"15","year":"2009","journal-title":"Liver Transpl"},{"key":"lt25205-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1136\/gut.52.6.893","article-title":"A 10 year follow up study of patients transplanted for autoimmune hepatitis: histological recurrence precedes clinical and biochemical recurrence","volume":"52","year":"2003","journal-title":"Gut"},{"key":"lt25205-bib-0008-20240115","article-title":"Histologic surveillance after liver transplantation due to autoimmune hepatitis","year":"2017","journal-title":"Clin Transplant"},{"key":"lt25205-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1002\/lt.21525","article-title":"Liver transplantation for autoimmune hepatitis and the success of aggressive corticosteroid withdrawal","volume":"14","year":"2008","journal-title":"Liver Transpl"},{"key":"lt25205-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"3311","DOI":"10.1016\/S0041-1345(02)03570-4","article-title":"Autoimmune hepatitis following liver transplantation: relationship to recurrent disease and steroid weaning","volume":"34","year":"2002","journal-title":"Transplant Proc"},{"key":"lt25205-bib-0011-20240115","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1097\/00007890-199812270-00013","article-title":"Outcome of autoimmune hepatitis after liver transplantation","volume":"66","year":"1998","journal-title":"Transplantation"},{"key":"lt25205-bib-0012-20240115","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1111\/j.1432-2277.2007.00628.x","article-title":"The impact of disease recurrence on graft survival following liver transplantation: a single centre experience","volume":"21","year":"2008","journal-title":"Transpl Int"},{"key":"lt25205-bib-0013-20240115","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S0168-8278(99)80017-8","article-title":"Long\u2010term follow\u2010up after liver transplantation for autoimmune hepatitis: evidence of recurrence of primary disease","volume":"30","year":"1999","journal-title":"J Hepatol"},{"key":"lt25205-bib-0014-20240115","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/00007890-198404000-00009","article-title":"Recurrence of autoimmune chronic active hepatitis following orthotopic liver grafting","volume":"37","year":"1984","journal-title":"Transplantation"},{"key":"lt25205-bib-0015-20240115","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/j.1600-0676.1997.tb01038.x","article-title":"Acute lobular hepatitis as the first manifestation of recurrent autoimmune hepatitis after orthotopic liver transplantation","volume":"17","year":"1997","journal-title":"Liver"},{"key":"lt25205-bib-0016-20240115","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1002\/lt.500010305","article-title":"Recurrence of autoimmune hepatitis following liver transplantation","volume":"1","year":"1995","journal-title":"Liver Transpl Surg"},{"key":"lt25205-bib-0017-20240115","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/152692480101100312","article-title":"Steroid withdrawal in liver transplant recipients","volume":"11","year":"2001","journal-title":"Prog Transplant"},{"key":"lt25205-bib-0018-20240115","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1016\/S0041-1345(02)03004-X","article-title":"Steroid withdrawal under tacrolimus for primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis after liver transplantation and long\u2010term survival","volume":"34","year":"2002","journal-title":"Transplant Proc"},{"key":"lt25205-bib-0019-20240115","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1002\/lt.500050514","article-title":"Successful withdrawal of prednisone after adult liver transplantation for autoimmune hepatitis","volume":"5","year":"1999","journal-title":"Liver Transpl Surg"},{"key":"lt25205-bib-0020-20240115","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1016\/j.transproceed.2007.02.030","article-title":"Liver transplantation for autoimmune hepatitis: a single\u2010center experience","volume":"39","year":"2007","journal-title":"Transplant Proc"},{"key":"lt25205-bib-0021-20240115","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1097\/00007890-200104270-00016","article-title":"Reasons for long\u2010term use of steroid in primary adult liver transplantation under tacrolimus","volume":"71","year":"2001","journal-title":"Transplantation"},{"key":"lt25205-bib-0022-20240115","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.jhep.2013.09.020","article-title":"Autoimmune liver disease, autoimmunity and liver transplantation","volume":"60","year":"2014","journal-title":"J Hepatol"},{"key":"lt25205-bib-0023-20240115","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/lt.20123","article-title":"Immunosuppression affects the rate of recurrent primary biliary cirrhosis after liver transplantation","volume":"10","year":"2004","journal-title":"Liver Transpl"},{"issue":"suppl 2","key":"lt25205-bib-0024-20240115","first-page":"S25","article-title":"Recurrence of autoimmune disease, primary sclerosing cholangitis, primary biliary cirrhosis, and autoimmune hepatitis after liver transplantation","volume":"15","year":"2009","journal-title":"Liver Transpl"},{"key":"lt25205-bib-0025-20240115","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1111\/ajt.12132","article-title":"Calcineurin inhibitors and the IL12A locus influence risk of recurrent primary biliary cirrhosis after liver transplantation","volume":"13","year":"2013","journal-title":"Am J Transplant"},{"key":"lt25205-bib-0026-20240115","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.bpg.2011.09.008","article-title":"Liver transplantation in autoimmune liver diseases","volume":"25","year":"2011","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"lt25205-bib-0027-20240115","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1002\/lt.21260","article-title":"Risk factors for recurrence of primary sclerosing cholangitis after liver transplantation","volume":"14","year":"2008","journal-title":"Liver Transpl"},{"key":"lt25205-bib-0028-20240115","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/TP.0000000000000922","article-title":"Autoimmune liver disease post\u2010liver transplantation: a summary and proposed areas for future research","volume":"100","year":"2016","journal-title":"Transplantation"},{"key":"lt25205-bib-0029-20240115","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/liv.12027","article-title":"Liver transplantation for overlap syndromes of autoimmune liver diseases","volume":"33","year":"2013","journal-title":"Liver Int"},{"key":"lt25205-bib-0030-20240115","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1002\/lt.23704","article-title":"Liver transplantation and autoimmune liver diseases","volume":"19","year":"2013","journal-title":"Liver Transpl"},{"key":"lt25205-bib-0031-20240115","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1002\/lt.500040313","article-title":"Allograft rejection after liver transplantation for autoimmune liver diseases","volume":"4","year":"1998","journal-title":"Liver Transpl Surg"},{"key":"lt25205-bib-0032-20240115","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1002\/hep.510230207","article-title":"Incidence of rejection and infection after liver transplantation as a function of the primary disease: possible influence of alcohol and polyclonal immunoglobulins","volume":"23","year":"1996","journal-title":"Hepatology"},{"key":"lt25205-bib-0033-20240115","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1097\/00007890-200008150-00014","article-title":"Increased incidence of chronic rejection in adult patients transplanted for autoimmune hepatitis: assessment of risk factors","volume":"70","year":"2000","journal-title":"Transplantation"},{"key":"lt25205-bib-0034-20240115","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1399-0012.2004.00117.x","article-title":"Long\u2010term outcome of liver transplantation for autoimmune hepatitis","volume":"18","year":"2004","journal-title":"Clin Transplant"},{"key":"lt25205-bib-0035-20240115","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/apt.13894","article-title":"Systematic review: recurrent autoimmune liver diseases after liver transplantation","volume":"45","year":"2017","journal-title":"Aliment Pharmacol Ther"},{"key":"lt25205-bib-0036-20240115","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1600-6143.2010.03384.x","article-title":"Infectious complications more than 1 year after liver transplantation: a 3\u2010decade nationwide experience","volume":"11","year":"2011","journal-title":"Am J Transplant"},{"key":"lt25205-bib-0037-20240115","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1053\/jlts.2003.50044","article-title":"Osteoporosis after liver transplantation","volume":"9","year":"2003","journal-title":"Liver Transpl"},{"key":"lt25205-bib-0038-20240115","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1002\/lt.24323","article-title":"Longterm corticosteroid use after liver transplantation for autoimmune hepatitis is safe and associated with a lower incidence of recurrent disease","volume":"22","year":"2016","journal-title":"Liver Transpl"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.25205","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lt.25205","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lt.25205","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201808000-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T01:18:40Z","timestamp":1705281520000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201808000-00016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8]]},"references-count":38,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.25205","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8]]},"assertion":[{"value":"2017-09-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}