Steroid withdrawal under tacrolimus for primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis after liver transplantation and long-term survival

Abstract

END-STAGE liver failure from primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), and autoimmune hepatitis (AIH) are well recognized indications for liver transplantation (LT). Recurrence of autoimmune process in PBC, PSC, and AIH after LT is well recognized. Continuous small dose of steroids has been suggested to prevent the recurrence of disease. The longterm use of steroids obviously has disadvantages and it is generally accepted to avoid use of steroids as much as possible. The aims of the present study are to examine the long-term outcomes after LT for PBC, PSC, and AIH using tacrolimus and to review the requirements on when to use steroids.