Antibodies against glutathione S-transferase T1 (GSTT1) in patients with GSTT1 null genotype as prognostic marker: long-term follow-up after liver transplantation.

An objective to improve the evolution of transplants is to identify risk biomarkers of morbidity and loss of allograft. In liver transplant (LTX) recipients, an association has been demonstrated between the presence of mismatch for glutathione S-transferase T1 (GSTT1) and the development of de novo immune hepatitis (IH). In 419 LTX patients we analyzed, for a period of 1 to 14 years, the development of "atypical" autoantibodies directed against GSTT1 and their relationship with the mismatch for GSTT1 genotype and with the risk for developing de novo IH. A total of 6.9% LTX recipients had "atypical" autoantibodies and 24 showed mismatch (recipient/donor) for GSTT1 genotype. From this last group, up to 70% developed de novo IH and graft dysfunction after LTX (95% confidence interval: 17.4-37.5 months). In LTX recipients with a GSTT1 null genotype, the evaluation of "atypical" autoantibodies is useful for monitoring the development of de novo IH.