{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T23:01:34Z","timestamp":1756076494073,"version":"3.37.3"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:00:00Z","timestamp":1589155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:00:00Z","timestamp":1589155200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>The etiology and prognosis of acute liver failure (ALF) remains unknown in a significant proportion of cases. Signs of autoimmunity may be present, but no consistent pattern has been observed. We aimed to analyze if pretransplant immunological findings, human leukocyte antigen (HLA) haplotypes, and clinical features among patients with an unknown etiology differ from those of autoimmune or other known etiologies. We also analyzed whether such signs impact posttransplant biopsy findings or complications. All adult ALF patients undergoing liver transplantation (LT) in Finland during 1987\u20102015 were followed to 2016. Data were collected from the LT registry, pathology database, and patient records. A total of 124 patients were included in the analysis. Study subgroups were acute autoimmune hepatitis (AIH; n\u00a0=\u00a025), known non\u2010AIH etiology (n\u00a0=\u00a054), and unknown etiology (n\u00a0=\u00a045). The unknown etiology group differed from the known non\u2010AIH group with regard to the following pretransplant autoimmunity\u2010associated features: positive perinuclear anti\u2010neutrophil cytoplasmic antibodies (36% versus 8%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.02) and higher mean immunoglobulin A (IgA; 3.2\u00a0\u00b1\u00a01.7 versus 2.1\u00a0\u00b1\u00a01.4, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.006) and immunoglobulin G (IgG; 12.7\u00a0\u00b1\u00a04.3 versus 8.5\u00a0\u00b1\u00a03.6, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.001). AIH\u2010associated HLA haplotypes B8, DR3, and B8DR3 were more common in the AIH group (40%, 44%, and 36%, respectively) and in the unknown group (29%, 33%, and 29%, respectively) than in the known non\u2010AIH group (11%, 17%, and 11%, respectively) or in the Finnish general population (17%, 18%, and 8%, respectively). However, these findings had no association with protocol biopsies, extrahepatic autoimmune diseases, or survival. Patients with\u00a0\u2265\u00a01 rejection episode had higher pretransplant IgA (3.7\u00a0\u00b1\u00a02.3 versus 2.6\u00a0\u00b1 1.2; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.02) and IgG (16.4\u00a0\u00b1\u00a010.2 versus 12.4\u00a0\u00b1\u00a06.8; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.03) than those without rejections. Autoimmunity\u2010associated pretransplant laboratory findings and HLA haplotypes were common in ALF of unknown etiology, but they showed minimal predictive value for posttransplant biopsy findings, clinical complications, or survival.<\/jats:p>","DOI":"10.1002\/lt.25729","type":"journal-article","created":{"date-parts":[[2020,2,8]],"date-time":"2020-02-08T09:59:39Z","timestamp":1581155979000},"page":"764-773","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Role of Autoimmunity in Patients Transplanted for Acute Liver Failure of Unknown Origin: A Clinical and Graft Biopsy Analysis"],"prefix":"10.1097","volume":"26","author":[{"given":"Ville","family":"Liukkonen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology,Helsinki University Hospital,Helsinki,Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arno","family":"Nordin","sequence":"additional","affiliation":[{"name":"Transplantation and Liver Surgery Clinic,Helsinki University Hospital,Helsinki,Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Arola","sequence":"additional","affiliation":[{"name":"Department of Pathology,Laboratory of Helsinki University Hospital (HUSLAB),University of Helsinki,Helsinki,Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martti","family":"F\u00e4rkkil\u00e4","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Helsinki University Hospital,Helsinki,Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3833-0705","authenticated-orcid":false,"given":"Fredrik","family":"\u00c5berg","sequence":"additional","affiliation":[{"name":"Transplantation and Liver Surgery Clinic,Helsinki University Hospital,Helsinki,Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2020,5,11]]},"reference":[{"key":"lt25729-bib-0001-20240115","first-page":"282","article-title":"The management of fulminant hepatic failure","volume":"3","year":"1970","journal-title":"Prog Liver Dis"},{"issue":"Suppl 2","key":"lt25729-bib-0003-20240115","first-page":"184","article-title":"OPTN\/SRTR 2017 Annual Data Report: Liver","volume":"19","year":"2019","journal-title":"Am J Transplant"},{"key":"lt25729-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1001\/archinte.161.7.1013","article-title":"Non\u2010A, non\u2010B fulminant hepatic failure","volume":"161","year":"2001","journal-title":"Arch Intern Med"},{"key":"lt25729-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.bpg.2012.01.014","article-title":"Recent developments in acute liver 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