ppharmПедиатрическая фармакологияPediatric pharmacology1727-57762500-3089Издательство «ПедиатрЪ»10.15690/pf.v12i6.1492ppharm-1373Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWСовременные методы лечения детей с аутоиммунными заболеваниями печениContemporary Methods of Treating Children with Autoimmune Nephric DiseasesКостыркоЕ. В.KostyrkoE. V.

аспирант кафедры госпитальной педиатрии No 1 РНИМУ им. Н.И. Пирогова 

kostyrko.ev@mail.ruШумиловП. В.ShumilovP. V.Российский национальный исследовательский медицинский университет им. Н.И. Пирогова, Москва, Российская ФедерацияРоссияPirogov Russian National Medical Research University, Moscow, Russian FederationRussian Federation201512022016126679685Copyright © Костырко Е.В., Шумилов П.В., 20162016Костырко Е.В., Шумилов П.В.Kostyrko E.V., Shumilov P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pedpharma.ru/jour/article/view/1373

В обзоре проанализированы современные схемы терапии и их эффективность у детей с аутоиммунными заболеваниями печени. Описаны особенности применения стандартного режима терапии у детей, рассмотрены альтернативные схемы лечения с использованием циклоспорина, такролимуса, будесонида и урсодезоксихолевой кислоты, а также необходимость применения препаратов второй линии для лечения больных с резистентными случаями аутоиммунных заболеваний печени. Освещены перспективные направления лечения этой категории больных. 

The review is dedicated to the analysis of contemporary therapies and efficacy thereof for treating children autoimmune nephric diseases. The authors describe peculiarities of using the conventional therapy in children and discuss alternative treatments using cyclosporine, tacrolimus, budesonide and ursodeoxycholic acid, as well as the need in using the second-line drugs for treating patients with resistant autoimmune nephric diseases. The review touches upon the promising approaches to the treatment of this category of patients. 

детиаутоиммунные заболевания печениаутоиммунный гепатитаутоиммунный склерозирующий холангитлечениеchildrenautoimmune nephric diseasesautoimmune hepatitisautoimmune sclerosing cholangitistreatmentReferencesGregorio GV, Portmann B, Reid F. Donaldson PT, Doherty DG, McCartney M, Mowat AP, Vergani D, Mieli-Vergani G. Autoimmune hepatitis in childhood: a 20 year experience. Hepatology. 1997;25:541–547.Gregorio GV, Portmann B, Reid F. Donaldson PT, Doherty DG, McCartney M, Mowat AP, Vergani D, Mieli-Vergani G. Autoimmune hepatitis in childhood: a 20 year experience. Hepatology. 1997;25:541–547.Gregorio GV, Portmann B, Karani J, Harrison P, Donaldson PT, Vergani D, Mieli-Vergani G. Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood: a 16 year prospective study. Hepatology. 2001;33:544–553.Gregorio GV, Portmann B, Karani J, Harrison P, Donaldson PT, Vergani D, Mieli-Vergani G. Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood: a 16 year prospective study. Hepatology. 2001;33:544–553.European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol. 2015;63(4):971–1004.European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol. 2015;63(4):971–1004.Mieli-Vergani G, Vergani D. Paediatric autoimmune liver disease. Arch Dis Child. 2013;98(12):1012–1017.Mieli-Vergani G, Vergani D. Paediatric autoimmune liver disease. Arch Dis Child. 2013;98(12):1012–1017.Аутоиммунный гепатит у детей. Под ред. НЛ Пахомовской. М.: Форте принт. 2013. 36 с.Аутоиммунный гепатит у детей. Под ред. НЛ Пахомовской. М.: Форте принт. 2013. 36 с.Liberal R, Longhi MS, Miel-Vergani G, Vergani D. Pathogenesis of autoimmune hepatitis. Best Prac Res Clin Gastroenterol. 2011;25:653–664.Liberal R, Longhi MS, Miel-Vergani G, Vergani D. Pathogenesis of autoimmune hepatitis. Best Prac Res Clin Gastroenterol. 2011;25:653–664.Boberg KM. Prevalence and epidemiology of autoimmune hepatitis. Clin Liver Dis. 2002;6:635–647.Boberg KM. Prevalence and epidemiology of autoimmune hepatitis. Clin Liver Dis. 2002;6:635–647.Saadah OI, Smith AL, Hardikar W. Outcome of autoimmune hepatitis in children. J Gastroenterol Hepatol. 2001;16:1297–1302.Saadah OI, Smith AL, Hardikar W. Outcome of autoimmune hepatitis in children. J Gastroenterol Hepatol. 2001;16:1297–1302.Chong VH, Jalihal A, Telisinghe PU. Autoimmune hepatitis in adult and pediatric patients: is there any difference? Indian J Gastroenterol. 2015;34(3):264–265.Chong VH, Jalihal A, Telisinghe PU. Autoimmune hepatitis in adult and pediatric patients: is there any difference? Indian J Gastroenterol. 2015;34(3):264–265.Баранов АА, Каганов БС, Гундобина ОС, Чистова АВ, Тюрина АС, Сичинава ИВ, Ратникова МА, Готье СВ, Цирульникова ОМ, Зайнудинов ЗМ, Потапов АС, Дубченко ОВ. Клиническая картина и течение аутоиммунного гепатита 1-го и 2-го типов у детей. Педиатрия. Журнал им. Г.Н. Сперанского. 2003;82(1):42–49.Баранов АА, Каганов БС, Гундобина ОС, Чистова АВ, Тюрина АС, Сичинава ИВ, Ратникова МА, Готье СВ, Цирульникова ОМ, Зайнудинов ЗМ, Потапов АС, Дубченко ОВ. Клиническая картина и течение аутоиммунного гепатита 1-го и 2-го типов у детей. Педиатрия. Журнал им. Г.Н. Сперанского. 2003;82(1):42–49.Czaja AJ. Freese DK. Diagnosis and treatment of autoimmune hepatitis. Hepatology. 2002;36:479–497.Czaja AJ. Freese DK. Diagnosis and treatment of autoimmune hepatitis. Hepatology. 2002;36:479–497.Mistilis SP, Skyring AP, Blackburn CR. Natural history of active chronic hepatitis: I. Clinical features, course, diagnostic criteria, morbidity, mortality and survival. Australas Ann Med. 1968;17:214–223.Mistilis SP, Skyring AP, Blackburn CR. Natural history of active chronic hepatitis: I. Clinical features, course, diagnostic criteria, morbidity, mortality and survival. Australas Ann Med. 1968;17:214–223.Soloway RD, Summerskill WH, Baggenstoss AH, Geall MG. Clinical, biochemical, and histological remission of severe chronic active liver disease: a control study of treatment and early prognosis. Gastroenterology. 1972;63:820–833.Soloway RD, Summerskill WH, Baggenstoss AH, Geall MG. Clinical, biochemical, and histological remission of severe chronic active liver disease: a control study of treatment and early prognosis. Gastroenterology. 1972;63:820–833.Mieli-Vergani G, Heller S, Jara P, Vergani D, Chang MH, Fujisawa T, Gonzalez-Peralta RP, Kelly D, Mohan N, Shah U, Murray KF. Autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2009;49:158–164.Mieli-Vergani G, Heller S, Jara P, Vergani D, Chang MH, Fujisawa T, Gonzalez-Peralta RP, Kelly D, Mohan N, Shah U, Murray KF. Autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2009;49:158–164.Maggiore G, Nastasio S, Sciveres M. Juvenile autoimmune hepatitis: Spectrum of the disease. World J Hepatol. 2014;6(7):464–476.Maggiore G, Nastasio S, Sciveres M. Juvenile autoimmune hepatitis: Spectrum of the disease. World J Hepatol. 2014;6(7):464–476.Ferreira AR, Roquete ML, Toppa NH, de Castro LP, Fagundes ED, Penna FJ. Effect of treatment of hepatic histopathology in children and adolescents with autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2008;46:65–70.Ferreira AR, Roquete ML, Toppa NH, de Castro LP, Fagundes ED, Penna FJ. Effect of treatment of hepatic histopathology in children and adolescents with autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2008;46:65–70.Дворяковская ГМ, Гундобина ОС, Дворяковский ИВ, Каганов БС. Ультразвуковая оценка эффективности терапии при аутоиммунном гепатите у детей. Ультразвуковая и функциональная диагностика. 2005;4:44–51.Дворяковская ГМ, Гундобина ОС, Дворяковский ИВ, Каганов БС. Ультразвуковая оценка эффективности терапии при аутоиммунном гепатите у детей. Ультразвуковая и функциональная диагностика. 2005;4:44–51.Kerkar N, Annunziato RA, Foley L, Schmeidler J, Rumbo C, Emre S, Shneider B, Shemesh E. Prospective analysis of nonadherence in autoimmune hepatitis: a common problem. J Pediatr Gastroenterol Nutr. 2006;43:629–34.Kerkar N, Annunziato RA, Foley L, Schmeidler J, Rumbo C, Emre S, Shneider B, Shemesh E. Prospective analysis of nonadherence in autoimmune hepatitis: a common problem. J Pediatr Gastroenterol Nutr. 2006;43:629–34.Lee WS, Lum SH, Lim CB, Chong SY, Khoh KM, Ng RT, Teo KM, Boey CC, Pailoor J. Characteristics and outcome of autoimmune liver disease in Asian children. Hepatol Int. 2015;9(2):292–302.Lee WS, Lum SH, Lim CB, Chong SY, Khoh KM, Ng RT, Teo KM, Boey CC, Pailoor J. Characteristics and outcome of autoimmune liver disease in Asian children. Hepatol Int. 2015;9(2):292–302.Low AS, Tan M, Garcia A, Aw M, Quak SH. Childhood autoimmune hepatitis in a paediatric unit of a tertiary care hospital. Singapore Med J. 2014;55(12):648–651.Low AS, Tan M, Garcia A, Aw M, Quak SH. Childhood autoimmune hepatitis in a paediatric unit of a tertiary care hospital. Singapore Med J. 2014;55(12):648–651.Vergani D, Mieli-Vergani G. Pharmacological management of autoimmune hepatitis. Expert Opin Pharmacother. 2011;12:607–613.Vergani D, Mieli-Vergani G. Pharmacological management of autoimmune hepatitis. Expert Opin Pharmacother. 2011;12:607–613.Lennard L, Van Loon JA, Weinshilboum RM. Pharmacogenetics of acute azathioprine toxicity: relationship to thiopurine methyltransferase genetic polymorphism. Clin Pharmacol Ther. 1989;46:149–154.Lennard L, Van Loon JA, Weinshilboum RM. Pharmacogenetics of acute azathioprine toxicity: relationship to thiopurine methyltransferase genetic polymorphism. Clin Pharmacol Ther. 1989;46:149–154.Czaja AJ. Safety issues in the management of autoimmune hepatitis. Exp Opin Drug Saf. 2008;7:319–33.Czaja AJ. Safety issues in the management of autoimmune hepatitis. Exp Opin Drug Saf. 2008;7:319–33.Johnson PJ, McFarlane IG, Williams R. Azathioprine for long term maintenance of remission in autoimmune hepatitis. N Engl J Med. 1995;333:958–963.Johnson PJ, McFarlane IG, Williams R. Azathioprine for long term maintenance of remission in autoimmune hepatitis. N Engl J Med. 1995;333:958–963.Dumortier J, Arita CT, Rivet C, LeGall C, Bouvier R, Fabien N, Guillaud O, Collardeau-Frachon S, Scoazec JY, Lachaux A. Long term treatment reduction and steroids withdrawal in children with autoimmune hepatitis: a single centre experience on 55 children. Eur J Gastroenterol Hepatol. 2009;21(12):1413–1418.Dumortier J, Arita CT, Rivet C, LeGall C, Bouvier R, Fabien N, Guillaud O, Collardeau-Frachon S, Scoazec JY, Lachaux A. Long term treatment reduction and steroids withdrawal in children with autoimmune hepatitis: a single centre experience on 55 children. Eur J Gastroenterol Hepatol. 2009;21(12):1413–1418.Banerjee S, Rahhal R, Bishop WP. Azathioprine monotherapy for maintenance of remission in pediatric patients with autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2006;43(3):353–356.Banerjee S, Rahhal R, Bishop WP. Azathioprine monotherapy for maintenance of remission in pediatric patients with autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2006;43(3):353–356.Nadort C, Houwen RH, Stapelbroek JM. Re: Azathioprine monotherapy for maintenance of remission in pediatric patients with autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2007;45(4):490.Nadort C, Houwen RH, Stapelbroek JM. Re: Azathioprine monotherapy for maintenance of remission in pediatric patients with autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2007;45(4):490.Ravelli A, Lattanzi B, Consolaro A, Martini A. Glucocorticoids in paediatric rheumatology. Clin Exp Rheumatol. 2011;29:148–152.Ravelli A, Lattanzi B, Consolaro A, Martini A. Glucocorticoids in paediatric rheumatology. Clin Exp Rheumatol. 2011;29:148–152.Ruiz–Irastorza G, Danza A, Khamashta M. Glucocorticoid use and abuse in SLE. Rheumatology (Oxford). 2012;51(7):1145–1153.Ruiz–Irastorza G, Danza A, Khamashta M. Glucocorticoid use and abuse in SLE. Rheumatology (Oxford). 2012;51(7):1145–1153.Kauh E, Mixson L, Malice MP, Mesens S, Ramael S, Burke J, Reynders T, Van Dyck K, Beals C, Rosenberg E, Ruddy M. Prednisone affects inflammation, glucose tolerance, and bone turnover within hours of treatment in healthy individuals. Eur J Endocrinol. 2012;166:459–467.Kauh E, Mixson L, Malice MP, Mesens S, Ramael S, Burke J, Reynders T, Van Dyck K, Beals C, Rosenberg E, Ruddy M. Prednisone affects inflammation, glucose tolerance, and bone turnover within hours of treatment in healthy individuals. Eur J Endocrinol. 2012;166:459–467.Alvarez F, Ciocca M, Canero-Velasco C, Ramonet M, de Davila MT, Cuarterolo M, Gonzalez T, Jara-Vega P, Camarena C, Brochu P, Drut R, Alvarez E. Short term cyclosporine induces a remission of autoimmune hepatitis in children. J Hepatol. 1999;30:222–227.Alvarez F, Ciocca M, Canero-Velasco C, Ramonet M, de Davila MT, Cuarterolo M, Gonzalez T, Jara-Vega P, Camarena C, Brochu P, Drut R, Alvarez E. Short term cyclosporine induces a remission of autoimmune hepatitis in children. J Hepatol. 1999;30:222–227.Debray D, Maggiore G, Girardet JP, Mallet E, Bernard O. Efficacy of cyclosporin A in children with type 2 autoimmune hepatitis. J Pediatr. 1999;135:111–114.Debray D, Maggiore G, Girardet JP, Mallet E, Bernard O. Efficacy of cyclosporin A in children with type 2 autoimmune hepatitis. J Pediatr. 1999;135:111–114.Cuarterolo M, Ciocca M, Velasco CC, Ramonet M, Gonzalez T, Lopez S, Garsd A, Alvarez F. Follow up of children with autoimmune hepatitis treated with cyclosporine. J Pediatr Gastroenterol Nutr. 2006;43:635–639.Cuarterolo M, Ciocca M, Velasco CC, Ramonet M, Gonzalez T, Lopez S, Garsd A, Alvarez F. Follow up of children with autoimmune hepatitis treated with cyclosporine. J Pediatr Gastroenterol Nutr. 2006;43:635–639.Franulovic OZ, Rajacic N, Lesar T, Kuna AT, Moric BV. Cyclosporine induced biochemical remission in childhood autoimmune hepatitis. Coll Antropol. 2012;36(3):973–979.Franulovic OZ, Rajacic N, Lesar T, Kuna AT, Moric BV. Cyclosporine induced biochemical remission in childhood autoimmune hepatitis. Coll Antropol. 2012;36(3):973–979.Marlaka JR, Papadogiannakis N, Fischler B, Casswall TH, Beijer E, Nemeth A. Tacrolimus without or with the addition of conventional immunosuppressive treatment in juvenile autoimmune hepatitis. Acta Paediatr. 2012;101(9):993–999.Marlaka JR, Papadogiannakis N, Fischler B, Casswall TH, Beijer E, Nemeth A. Tacrolimus without or with the addition of conventional immunosuppressive treatment in juvenile autoimmune hepatitis. Acta Paediatr. 2012;101(9):993–999.Manns MP, Woynarowski M, Kreisel W, Lurie Y, Rust C, Zuckerman E, Bahr MJ, Gunther R, Hultcrantz RW, Spengler U, Lohse AW, Szalay F, Farkkila M, Prols M, Strassburg CP. Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis. Gastroenterology. 2010; 139:1198–1206.Manns MP, Woynarowski M, Kreisel W, Lurie Y, Rust C, Zuckerman E, Bahr MJ, Gunther R, Hultcrantz RW, Spengler U, Lohse AW, Szalay F, Farkkila M, Prols M, Strassburg CP. Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis. Gastroenterology. 2010; 139:1198–1206.Woynarowski M, Nemeth A, Baruch Y, Koletzko S, Melter M, Rodeck B, Strassburg CP, Prols M, Wozniak M, Manns MP. Budesonide vs prednisone with azathioprine for the treatment of autoimmune hepatitis in children and adolescents. J Pediatr. 2013;163:1347–53.Woynarowski M, Nemeth A, Baruch Y, Koletzko S, Melter M, Rodeck B, Strassburg CP, Prols M, Wozniak M, Manns MP. Budesonide vs prednisone with azathioprine for the treatment of autoimmune hepatitis in children and adolescents. J Pediatr. 2013;163:1347–53.Mieli-Vergani G., Vergani D. Budesonide for juvenile autoimmune hepatitis? Not yet. J Pediatr. 2013;163(5):1246–1248.Mieli-Vergani G., Vergani D. Budesonide for juvenile autoimmune hepatitis? Not yet. J Pediatr. 2013;163(5):1246–1248.Рейзис АР, Хохлова ОН, Дрондина АК. Новые аспекты проблемы аутоиммунного гепатита: раннее распознавание и альтернативное лечение. Доктор.Ру. 2011;2(61):57–63.Рейзис АР, Хохлова ОН, Дрондина АК. Новые аспекты проблемы аутоиммунного гепатита: раннее распознавание и альтернативное лечение. Доктор.Ру. 2011;2(61):57–63.Lindor KD, Kowdley KV, Luketic VA, Harrison ME, McCashland T, Befeler AS, Harnois D, Jorgensen R, Petz J, Keach J, Mooney J, Sargeant C, Braaten J, Bernard T, King D, Miceli E, Schmoll J, Hoskin T, Thapa P, Enders F. High dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis. Hepatology. 2009;50:808–814.Lindor KD, Kowdley KV, Luketic VA, Harrison ME, McCashland T, Befeler AS, Harnois D, Jorgensen R, Petz J, Keach J, Mooney J, Sargeant C, Braaten J, Bernard T, King D, Miceli E, Schmoll J, Hoskin T, Thapa P, Enders F. High dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis. Hepatology. 2009;50:808–814.Alvarez F, Berg PA, Bianchi FB, Burroughs AK, Cancado EL, Chapman RW, Cooksley WG, Czaja AJ, Desmet VJ, Donaldson PT, Eddleston AL, Fainboim L, Heathcote J, Homberg JC, Hoofnagle JH, Kakumu S, Krawitt EL, Mackay IR, MacSween RN, Maddrey WC, Manns MP, McFarlane IG, Meyer zum Buschenfelde KH, Zeniya M. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol. 1999;31(5):929–938.Alvarez F, Berg PA, Bianchi FB, Burroughs AK, Cancado EL, Chapman RW, Cooksley WG, Czaja AJ, Desmet VJ, Donaldson PT, Eddleston AL, Fainboim L, Heathcote J, Homberg JC, Hoofnagle JH, Kakumu S, Krawitt EL, Mackay IR, MacSween RN, Maddrey WC, Manns MP, McFarlane IG, Meyer zum Buschenfelde KH, Zeniya M. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol. 1999;31(5):929–938.Aw MM, Dhawan A, Samyn M, Bargiota A, Mieli–Vergani G. Mycophenolate mofetil as rescue treatment for autoimmune liver disease in children: a 5 year follow up. J Hepatol. 2009;51:156–160.Aw MM, Dhawan A, Samyn M, Bargiota A, Mieli–Vergani G. Mycophenolate mofetil as rescue treatment for autoimmune liver disease in children: a 5 year follow up. J Hepatol. 2009;51:156–160.Mieli-Vergani G., Vergani D. Autoimmune Hepatitis in Childhood. Clinical Liver Disease. 2014;3(1):6–8.Mieli-Vergani G., Vergani D. Autoimmune Hepatitis in Childhood. Clinical Liver Disease. 2014;3(1):6–8.D’Agostino D, Costaguta A, Alvarez F. Successful treatment of refractory autoimmune hepatitis with rituximab. Pediatrics. 2013; 132:526–530.D’Agostino D, Costaguta A, Alvarez F. Successful treatment of refractory autoimmune hepatitis with rituximab. Pediatrics. 2013; 132:526–530.Rajanayagam J, Lewindon PJ. Infliximab as rescue therapy in paediatric autoimmune hepatitis. J Hepatol. 2013;59(4):908–909.Rajanayagam J, Lewindon PJ. Infliximab as rescue therapy in paediatric autoimmune hepatitis. J Hepatol. 2013;59(4):908–909.Gregorio GV, McFarlane B, Bracken P, Vergani D, Mieli-Vergani G. Organ and non-organ specific autoantibody titres and IgG levels as markers of disease activity: a longitudinal study in childhood autoimmune liver disease. Autoimmunity. 2002;35:515–19.Gregorio GV, McFarlane B, Bracken P, Vergani D, Mieli-Vergani G. Organ and non-organ specific autoantibody titres and IgG levels as markers of disease activity: a longitudinal study in childhood autoimmune liver disease. Autoimmunity. 2002;35:515–19.Maggiore G, Bernard O, Hadchouel M, Hadchouel P, Odievre M, Alagille D. Treatment of autoimmune chronic active hepatitis in childhood. J Pediatr. 1984;104:839–844.Maggiore G, Bernard O, Hadchouel M, Hadchouel P, Odievre M, Alagille D. Treatment of autoimmune chronic active hepatitis in childhood. J Pediatr. 1984;104:839–844.Mieli-Vergani G, Vergani D. Autoimmune liver disease in Asian children. Hepatol Int. 2015;9(2):157–160.Mieli-Vergani G, Vergani D. Autoimmune liver disease in Asian children. Hepatol Int. 2015;9(2):157–160.Radhakrishnan KR, Alkhouri N, Wolrley S, Arrigain S, Hupertz V, Kay M, Yerian L, Wyllie R, Feldstein AE. Autoimmune hepatitis in children — impact of cirrhosis at presentation on natural history and long term outcome. Dig Liver Dis. 2010;42:724–728.Radhakrishnan KR, Alkhouri N, Wolrley S, Arrigain S, Hupertz V, Kay M, Yerian L, Wyllie R, Feldstein AE. Autoimmune hepatitis in children — impact of cirrhosis at presentation on natural history and long term outcome. Dig Liver Dis. 2010;42:724–728.Kirstein MM, Metzler F, Geiger E, Heinrich E, Hallensleben M, Manns MP, Vogel A. Prediction of short and long term outcome in patients with autoimmune hepatitis. Hepatology. 2015; 62(5):1524–1535.Kirstein MM, Metzler F, Geiger E, Heinrich E, Hallensleben M, Manns MP, Vogel A. Prediction of short and long term outcome in patients with autoimmune hepatitis. Hepatology. 2015; 62(5):1524–1535.Chai PF, Lee WS, Brown RM, McPartland JL, Foster K, McKiernan PJ, Kelly DA. Childhood autoimmune liver disease: indications and outcome of liver transplantation. J Pediatr Gastroenterol Nutr. 2010;50:295–302.Chai PF, Lee WS, Brown RM, McPartland JL, Foster K, McKiernan PJ, Kelly DA. Childhood autoimmune liver disease: indications and outcome of liver transplantation. J Pediatr Gastroenterol Nutr. 2010;50:295–302.Martin SR, Alvarez F, Anand R, Song C, Yin W. Outcomes in children who underwent transplantation for autoimmune hepatitis. Liver Transpl. 2011;17:393–401.Martin SR, Alvarez F, Anand R, Song C, Yin W. Outcomes in children who underwent transplantation for autoimmune hepatitis. Liver Transpl. 2011;17:393–401.Liberal R, Zen Y, Mieli-Vergani G, Vergani D. Liver transplantation and autoimmune liver diseases. Liver Transpl. 2013;19:1065–1077.Liberal R, Zen Y, Mieli-Vergani G, Vergani D. Liver transplantation and autoimmune liver diseases. Liver Transpl. 2013;19:1065–1077.Kerkar N, Hadzic N, Davies ET, Portmann B, Donaldson PT, Rela M, Heaton ND, Vergani D, Mieli-Vergani G. De–novo autoimmune hepatitis after liver transplantation. Lancet. 1998;351:409–413.Kerkar N, Hadzic N, Davies ET, Portmann B, Donaldson PT, Rela M, Heaton ND, Vergani D, Mieli-Vergani G. De–novo autoimmune hepatitis after liver transplantation. Lancet. 1998;351:409–413.Kerkar N, Dugan C, Rumbo C., Morotti RA, Gondolesi G, Shneider BL, Emre S. Rapamycin successfully treats post-transplant autoimmune hepatitis. Am. J. Transplant. 2005;5(5):1085–1089.Kerkar N, Dugan C, Rumbo C., Morotti RA, Gondolesi G, Shneider BL, Emre S. Rapamycin successfully treats post-transplant autoimmune hepatitis. Am. J. Transplant. 2005;5(5):1085–1089.Ytting H, Larsen FS. Everolimus treatment for patients with autoimmune hepatitis and poor response to standard therapy and drug alternatives in use. Scand J Gastroenterol. 2015;50(8):1025–1031.Ytting H, Larsen FS. Everolimus treatment for patients with autoimmune hepatitis and poor response to standard therapy and drug alternatives in use. Scand J Gastroenterol. 2015;50(8):1025–1031.Chatrath H, Allen L, Boyer TD. Use of sirolimus in the treatment of refractory autoimmune hepatitis. Am J Med. 2014; 127(11):1128–1131.Chatrath H, Allen L, Boyer TD. Use of sirolimus in the treatment of refractory autoimmune hepatitis. Am J Med. 2014; 127(11):1128–1131.Sahebjam F, Vierling JM. Autoimmune hepatitis. Front Med. 2015;9(2):187–219.Sahebjam F, Vierling JM. Autoimmune hepatitis. Front Med. 2015;9(2):187–219.Simtuzumab (GS-6624) in the Prevention of Progression of Liver Fibrosis in Subjects With Primary Sclerosing Cholangitis (PSC). URL: https://clinicaltrials.gov/ct2/show/NCT01672853 (Available: 21.09.2015).Simtuzumab (GS-6624) in the Prevention of Progression of Liver Fibrosis in Subjects With Primary Sclerosing Cholangitis (PSC). URL: https://clinicaltrials.gov/ct2/show/NCT01672853 (Available: 21.09.2015).Simtuzumab (GS-6624) in the Treatment of Cirrhosis Due to NASH. URL: https://clinicaltrials.gov/ct2/show/NCT01672879 (Available: 21.10.2015).Simtuzumab (GS-6624) in the Treatment of Cirrhosis Due to NASH. URL: https://clinicaltrials.gov/ct2/show/NCT01672879 (Available: 21.10.2015).Safety and Efficacy of Simtuzumab (GS-6624) in Adults With Advanced Liver Fibrosis But Not Cirrhosis Secondary to NonAlcoholic Steatohepatitis (NASH). URL: https://clinicaltrials.gov/ ct2/show/NCT01672866 (Available: 21.10.2015).Safety and Efficacy of Simtuzumab (GS-6624) in Adults With Advanced Liver Fibrosis But Not Cirrhosis Secondary to NonAlcoholic Steatohepatitis (NASH). URL: https://clinicaltrials.gov/ ct2/show/NCT01672866 (Available: 21.10.2015).

The authors declare that there are no conflicts of interest present.