Use of Erythropoietin to Expand Regulatory T Cells in Autoimmune Liver Disease

Inclusion Criteria: * Diagnosis of autoimmune liver diseases (autoimmune hepatitis, autoimmune cholangiopathy, or primary biliary cirrhosis or primary sclerosing cholangitis with hepatic autoimmune liver disease or overlap syndrome) confirmed on liver biopsy * Use of immunosuppressive therapy (prednisone, azathioprine, 6-mercaptopurine, mycophenolate mofetil) for the treatment of the autoimmune liver disease * Stable immunosuppression regimen at least 6 months prior to enrollment * Ability to provide verbal and written informed consent Exclusion Criteria: * Diagnosis of decompensated cirrhosis (defined by presence of ascites, varices, encephalopathy) * Hemoglobin above average normal value (15.7 g/dL in men, 13.8 g/dL in women) * Alanine aminotransferase greater than 2 times upper limit of normal (33 IU/L in men and 25 IU/L in women) * Uncontrolled hypertension with systolic blood pressure greater than or equal to 160 or diastolic blood pressure greater than or equal to 100 * End-stage renal disease on hemodialysis * History of venous thromboembolism including deep vein thromboses or pulmonary emboli * History of stroke * History of heart failure * History of seizure disorder * History of significant cardiovascular disease including a history of myocardial infarction * Active malignancy (untreated or undergoing therapy) * History of pure red cell aplasia * History of intolerance or allergy to erythropoietin * Known hypersensitivity to mammalian cell-derived products * Known hypersensitivity to human albumin * Presence of vascular access * Prior recipient of erythropoietin within 12 weeks of the study * Patient unable to provide consent including infants, children, teenagers, prisoners, cognitively impaired adults * Non-English speaking * Pregnancy