| Title: |
Early liver transplantation for corticosteroid non-responders in acute severe autoimmune hepatitis: the surfasa score |
| Authors: |
De Martin, Eleonora; Chazouilleres, Olivier; Roux, Olivier; Peron, Jean-Marie; Houssel-Debry, Pauline; Artru, Florent; Silvain, Christine; Ollivier-Hourmand, Isabelle; Duvoux, Christophe; Heurgue-Berlot, Alexandra; Barge, Sandrine; Ganne-Carrie, Nathalie; Pageaux, Georges-Philippe; Besch, Camille; Bourliere, Marc; Fontaine, Helene; De Ledinghen, Victor; Dumortier, Jerome; Conti, Filomena; Radenne, Sylvie; Debette-Gratien, Maryline; Goria, Odile; Durand, Francois; Potier, Pascal; Di Martino, Vincent; Reboux, Noemi; Ichai, Philippe; Sebagh, Mylene; Mathurin, Philippe; Agostini, Helene; Samuel, Didier; Duclos-Vallee, Jean-Charles |
| Contributors: |
CHU Lille; Inserm; Université de Lille; Centre Hépato-Biliaire Hôpital Paul Brousse CHB; CHU Saint-Antoine AP-HP; Hôpital Beaujon AP-HP; Centre Hospitalier Universitaire de Toulouse CHU Toulouse; Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou; Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286; Centre hospitalier universitaire de Poitiers = Poitiers University Hospital CHU de Poitiers; Service d'Hépato-Gastro-Enterologie et Nutrition CHU Caen; Service d'hépato-gastro-entérologie APHP Henri Mondor; Hôpital universitaire Robert Debré Reims; Hôpital Jean Verdier AP-HP; Département d'Hépato-Gastroentérologie et de Transplantation Hépatique CHU Saint-Eloi; Les Hôpitaux Universitaires de Strasbourg (HUS); Hôpital Saint-Joseph Marseille; Département d'hépatologie CHU Cochin; CHU Bordeaux; Hôpital Edouard Herriot CHU - HCL; CHU Pitié-Salpêtrière AP-HP; Service d'Hépatologie Hôpital de la Croix-Rousse - HCL; Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges; Service d'Hépato-Gastroentérologie CHU Rouen; Centre Hospitalier Régional d'Orléans CHRO; Hôpital JeanMinjoz; Centre Hospitalier Régional Universitaire de Brest CHRU Brest; AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre) |
| Publication Year: |
2024 |
| Collection: |
LillOA (Lille Open Archive - Université de Lille) |
| Subject Terms: |
Severe acute hepatitis; liver transplantation; autoimmune hepatitis; corticosteroid therapy; prognostic score |
| Description: |
OBJECTIVE: In acute severe autoimmune hepatitis (AS-AIH), the optimal timing for liver transplantation (LT) remains controversial. The objectives of this study were to determine early predictive factors for a non-response to corticosteroids and to propose a score to identify patients in whom LT is urgently indicated. METHODS: This was a retrospective, multicenter study (2009-2016). A diagnosis of AS-AIH was based on: i) Definite or probable AIH based on the simplified IAIHG score; ii) international normalized ratio (INR) ≥1.5 and/or bilirubin >200 μmol/L; iii) No previous history of AIH; iv) Histologically proven AIH. A treatment response was defined as LT-free survival at 90 days. The evolution of variables from corticosteroid initiation (day-D0) to D3 was estimated from: Δ%3 = (D3-D0)/D0. RESULTS: A total of 128 patients were included, with a median age of 52 (39-62) years; 72% were female. Overall survival reached 88%. One hundred and fifteen (90%) patients received corticosteroids, with a LT-free survival rate of 66% at 90 days. Under multivariate analysis, D0-INR (odds ratio [OR] 6.85; 95% CI 2.23-21.06; p |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
Journal of hepatology; J Hepatol; http://hdl.handle.net/20.500.12210/40884 |
| Availability: |
https://hdl.handle.net/20.500.12210/40884 |
| Rights: |
info:eu-repo/semantics/closedAccess |
| Accession Number: |
edsbas.83C3EAA9 |
| Database: |
BASE |