Living donor liver transplantation for autoimmune hepatitis in identical monozygotic twins: a case report

Liver transplantation (LT) is an effective treatment for end-stage liver diseases, including autoimmune hepatitis. Advances in immunosuppressive therapy have improved patient and graft survival; however, these treatments can cause serious side effects such as cardiovascular and metabolic complications. Some recipients achieve immunotolerance after LT, enabling them to safely reduce or even discontinue immunosuppression. In transplantation between identical twins, perfect human leukocyte antigen matching eliminates the need for immunosuppressive medications, thereby reducing long-term morbidity. We present a case of living donor LT between identical twins in which both the donor and recipient have remained healthy for over 2 years without the need for immunosuppression.