[149] COMPLICATIONS IN LIVING LIVER DONOR ACCORDING TO CLAVIEN'S CLASSIFICATION: AN EUROPEAN EXPERIENCE

S66POSTERS review the diagnosis ofde novo ATH in adult liver transplanted pts followed at our Center.Methods: We included all the 130 adult pts (107 male; median age 54 yrs, range 16-66) who underwent cadaveric liver transplantation (LT) from 1988 to 2005 and were followed up at our Center.The indication for LT was viral hepatitis in 102 pts, alcoholic disease in 14, cryptogenic cirrhosis in 6 while AIH, hepatic fibrosis, Wilson disease, Caroli disease, Budd-Chiari syndrome and fulminant hepatic failure accounted for 1 pt each.Results: Ten pts (4 male; median age 58.5 yrs) of 130 (7.7%) developed a form of otherwise unexplained graft dysfunction characterized by histological and serological findings of ATH after a median period after LT of 63 mo (range 9-144).Among them, 6 were transplanted for HCV cirrhosis, 3 for cryptogenic and I for alcohol related cirrhosis.All 10 pts showed liver tests abnormalities associated to mononuclear-cell infiltrate invading the limiting plate at liver biopsy.Antinuclear antibodies were detected in 5 pts, smooth muscle antibodies in 2, neutrophil cytoplasmic antigens antibodies in 1, while 2 pts showed anti-thyroid antibodies.The AIH scoring system was probable in 9 pts and definite in 1. Pts were treated with prednisone and azathioprine or mycofenolate, with regression of liver test abnormalities in 9. Reviewing cryptogenic cirrhosis, ATH scoring system probable in 2 pts and definite in the other (unrecognized ATH ah initio); all HCV pts developed features of de novo AIH during or soon after the treatment with pegylated interferon.Conclusions: In our experience, in 9/10 pts previously labelled as de novo ATH a iatrogenic trigger or an understimated pre-LT disease was detectable: these results suggest to better characterize the cases currently defined as "de novo" AIH in post transplant setting. 11481