Abatacept for Treatment of Recurrent or de Novo Autoimmune Hepatitis

Inclusion Criteria for de novo AIH * Age 18 or older * Patients who have biopsy evidence of autoimmune liver disease following liver transplantation and a different pre-transplant etiology of liver disease will be eligible. * Patients who have been treated with steroids or other immunosuppressive agents for at least a month and who have not responded either with respect to normalization of liver function tests or biopsy evidence of hepatitis will be eligible. * Ability to provide signed and dated IRB approved written consent in accordance with regulatory and institutional guidelines prior to any protocol-related procedure. * Women of child bearing potential agree to have pregnancy test at screening * Males agree use of appropriate contraceptives during the active Orenia dosing period Inclusion Criteria for recurrent AIH * Age 18 or older * Patients who have biopsy evidence of autoimmune liver disease following liver transplantation and whose original etiology of liver disease was AIH will be eligible. * Patients who have been treated with steroids or other immunosuppressive agents for at least a month and who have not responded either with respect to normalization of liver function tests or biopsy evidence of hepatitis will be eligible. * Ability to provide signed and dated IRB approved written consent in accordance with regulatory and institutional guidelines prior to any protocol-related procedure. * Women of child bearing potential agree to have pregnancy test at screening * Males agree use of appropriate contraceptives during the active Orenia dosing period Exclusion Criteria: * Active systemic infection * Allergy to abatacept * Known malignancy in the previous 2 years except for non-melanoma skin cancer * Pregnancy or breast feeding * Inability to commit to complete treatment protocol at Duke, as all procedures must be completed at Duke * Prisoners or those who are compulsory detained * Inability to read and understand English * EBV seronegative (if not tested within 2 years prior to study enrollment, then testing will be done prior to study enrollment, results must be positive for study participation)