AIH questions from a NON AIHer

There has  been a rush on the AIH posters lately and I am learning so much...though thankful we are ONLY dealing with Hep C and aortic stenosis Post Transplant at our house. ONLY?

1. Hep C can (often) return post transplant as it has with Mike, who faces another round of treatment when he is strong enough...or, more likely, increased Hep C symptoms over time.

Does AIH come back after transplant in cases that get to the transplant stage?

2.  One of the recent posts said that those who successfully battled Toxic Hepatitis may find they are left with chronic AIH.  Would that be the case if the person with Toxic Hepatitis had a transplant? 

Would the body continue to attack a new liver?

Thanks, Carol

Hi Carol

Wow what good questions!

1. From what I have read yes AIH can return post transplant. To reduce this risk most transplant centres (at least here in UK but I assume everywhere) recommend that part of the immunosuppression regime is pred or budesonide long term - unlike other transplant recipients where they usually wean you totally off steroids after a time. A low dose like 2.5mg or 5mg (or the equivalent in budesonide) seems to be enough to keep it at bay without serious side effects. They don't know why it works but it does!

2. Um - not sure about this - Dany may know more. My guess and it is only a guess is that the toxic hepatitis can be the trigger for AIH - you know triggers can include viruses, meds or whatever (and they don't really understand this either!). In that case then my logic would be that if the need for transplant was 'purely' the toxic hepatitis - i.e. the med itself caused the severe damage then it probably wouldn't lead to AIH post transplant. But if the toxic hepatitis had already triggered the AIH then the answer to number 1. may apply.

Happy to be corrected - most of this is just a guess.

However most damage with AIH is done prior to diagnosis when the individual doesn't know anything is wrong as the symptoms are either non existent or very general. Post transplant you get so many tests that the AIH would be picked up very quickly and treated before any significant damage has been done.

Ann

  Nope, we're both on the same page!