The Liver Meeting 2022-Cholestatic & Autoimmune Liver Diseases SIG and Liver Transplant & Surgery SIG Program: Optimizing Pre- and Post-Transplant Management of Immune Mediated Liver Disease. PART 2

Cholestatic & Autoimmune Liver Diseases SIG and Liver Transplant & Surgery SIG Program: Optimizing Pre- and Post-Transplant Management of Immune Mediated Liver Disease. PART 2

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Video Transcription

Video Summary

Dr. Josh Levitsky discusses the management of patients with autoimmune liver disease after liver transplant. He focuses on autoimmune hepatitis, primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). Dr. Levitsky explains the risk of rejection and recurrent disease in each of these conditions and how immunosuppression may impact the risk. He also discusses monitoring strategies and the potential for immunosuppression withdrawal in patients with autoimmune hepatitis. For PBC, he mentions recurrence rates and the potential impact of tacrolimus therapy. For PSC, he discusses the importance of monitoring for rejection and bile duct damage. Dr. Levitsky highlights the need for further research in this area to develop better strategies for monitoring and immunosuppression. The second part of the video focuses on optimizing care for patients with liver disease. The speakers discuss the limitations of liver function tests and the use of elastography to assess fibrosis, inflammation, and fluid. They emphasize the role of limited protocol biopsy in predicting the need for immunosuppression and optimizing treatment. In patients with inflammatory bowel disease (IBD) and PSC, they stress the importance of hepatologists in managing IBD. Recurrence of PSC after transplantation is addressed, and the speakers discuss monitoring for the development of IBD and the potential use of vancomycin in treating colitis. Overall, the video emphasizes the need for more research and the challenges in managing autoimmune liver disease after liver transplant.

Keywords

autoimmune liver disease

liver transplant

autoimmune hepatitis

primary biliary cholangitis

primary sclerosing cholangitis

rejection

immunosuppression

monitoring strategies

tacrolimus therapy

bile duct damage

elastography

limited protocol biopsy

inflammatory bowel disease