Influence of socioeconomic factors on liver transplant survival outcomes in patients with autoimmune liver disease in the United States

Sierra, Leandro; Marenco-Flores, Ana; Barba, Romelia; Goyes, Daniela; Ferrigno, Bryan; Diaz, Wilfor; Medina-Morales, Esli; Saberi, Behnam; Patwardhan, Vilas R; Bonder, Alan

doi:10.1016/j.aohep.2023.101283

Cited by 6 publications

(1 citation statement)

References 29 publications

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“…Post-LT, determining the appropriate candidates for immunosuppressive maintenance therapy is crucial in the management of AIH [52,53]. Immunosuppressive protocols aim to strike a balance between the long-term morbidity and mortality risks in AIH patients following LT.…”

Section: Liver Transplantationmentioning

confidence: 99%

Autoimmune Hepatitis Management: Recent Advances and Future Prospects

Sierra,

Marenco-Flores,

Alsaqa

et al. 2024

Livers

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Autoimmune hepatitis (AIH) is a varied inflammatory chronic liver disease. AIH’s prevalence varies and has increased recently. Diagnosis involves the discovery of histologic features following liver biopsy and serologic testing. Clinical features vary, and up to 40% of patients may be asymptomatic. Evaluating thiopurine methyltransferase (TMPM) activity before treatment is crucial for an optimal response. The primary treatment goal is biochemical remission, normalized serum IgG, and liver enzymes. Induction therapy typically involves azathioprine and corticosteroids. Close monitoring of liver function tests and serum immunoglobulin levels is essential. Medications can be tapered after achieving biochemical remission. Liver transplantation may be required for refractory disease or cirrhosis. Further therapeutic approaches are needed, particularly for non-responders to first-line treatments.

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Section: Liver Transplantationmentioning

confidence: 99%

Autoimmune Hepatitis Management: Recent Advances and Future Prospects

Sierra,

Marenco-Flores,

Alsaqa

et al. 2024

Livers

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Predictors of poor postoperative outcomes in liver transplant patients

Buldukoglu

2024

Annals of Hepatology

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Low socioeconomic status exacerbates unmet health‐related needs in patients with autoimmune hepatitis

Singleton,

Carter,

Baker

et al. 2024

Aliment Pharmacol Ther

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SummaryBackground and AimsDiminished quality of life has been well characterized in patients with autoimmune hepatitis (AIH); however, the full spectrum of unmet needs is unclear. We hypothesized that there is a high burden of health‐related unmet needs in patients with AIH, and this burden differs by socioeconomic status (SES).MethodsMembers of the Autoimmune Hepatitis Association were invited online and by email to complete a modified version of the Systemic Lupus Erythematosus Patient Needs Questionnaire. Demographic and clinical data were also captured. Low SES was defined as annual household income <30 k, education level below high school, or moderate–high concern for transportation, food or housing. Multivariable logistic regression assessed the association between unmet health‐related needs and SES.ResultsThere were 433 participants; 89.8% identified as women, 16.2% lived outside the US, and 25.6% were classified as low SES. Over 70% of respondents reported at least one moderate–high need in the health‐related unmet need domains. In multivariable logistic regression, patients in the low‐SES group reported significantly higher odds of unmet needs compared to the moderate–high‐SES group: for adequate information about side effects (OR 1.64, 95% CI 1.06–2.53, p = 0.026), opportunity to speak with others with AIH (OR 2.34, 95% CI 1.50–3.66, p < 0.001), healthcare professionals acknowledging patient emotions (OR 2.41, 95% CI 1.56–3.74, p < 0.001) and being taken seriously by medical providers (OR 2.09, 95% CI 1.34–3.28, p = 0.001).ConclusionThere is a high burden of health‐related unmet needs in all patients with AIH that is exacerbated by low SES.

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Influence of socioeconomic factors on liver transplant survival outcomes in patients with autoimmune liver disease in the United States

Cited by 6 publications

References 29 publications

Autoimmune Hepatitis Management: Recent Advances and Future Prospects

Autoimmune Hepatitis Management: Recent Advances and Future Prospects

Predictors of poor postoperative outcomes in liver transplant patients

Low socioeconomic status exacerbates unmet health‐related needs in patients with autoimmune hepatitis

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