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Immunosuppressants Benefit Children With Liver Failure

Most children with autoimmune hepatitis treated with immunosuppressants recover liver function

MONDAY, Feb. 21 (HealthDay News) -- Most children with autoimmune hepatitis (AIH) who have liver failure respond well to immunosuppression therapy and can delay or avoid liver transplants, according to a study published in the February issue of Clinical Gastroenterology and Hepatology.

Miriam L. Cuarterolo, M.D., from the Hospital de Pediatría Juan P. Garrahan in Buenos Aires, Argentina, and colleagues examined data from 50 pediatric patients with AIH who had liver failure between 1996 and 2008. Liver failure was defined as prothrombin time of less than 50 percent. Patients were treated with 2 mg/kg prednisone per day at doses of up to 60 mg per day, or 1 mg/kg prednisone per day up to 40 mg per day plus cyclosporine.

The investigators found that both approaches were similarly effective. Forty-five of the children (90 percent) achieved prothrombin time of greater than 50 percent in an average of 24 days. Of these patients, two required liver transplants because of portal hypertension complications and three died from infection. Of the five nonresponders, three received transplants, one remained on the waiting list, and one died from central nervous system bleeding.

"In our patients with cirrhosis secondary to AIH and showing signs of liver failure at diagnosis, immunosuppressive treatment led to permanent recovery of liver function. Liver transplantation could be avoided or delayed in most patients," the authors write.

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