Recurrence of primary sclerosing cholangitis after liver transplantation - analysing the European Liver Transplant Registry and beyond

European Liver Intestine Transplan, Thijmen Visseren, Nicole Stephanie Erler, Wojciech Grzegorz Polak, Rene Adam, Vincent Karam, Florian Wolfgang Rudolf Vondran, Bo-Goran Ericzon, Douglas Thorburn, Jan Nicolaas Maria IJzermans, Andreas Paul, Frans van der Heide, Pavel Taimr, Petr Nemec, Jacques Pirenne, Renato Romagnoli, Herold Johnny Metselaar, Sarwa Darwish Murad*

*Corresponding author voor dit werk

    OnderzoeksoutputAcademicpeer review

    29 Citaten (Scopus)
    60 Downloads (Pure)

    Samenvatting

    Liver transplantation for primary sclerosing cholangitis (PSC) can be complicated by recurrence of PSC (rPSC). This may compromise graft survival but the effect on patient survival is less clear. We investigated the effect of post-transplant rPSC on graft and patient survival in a large European cohort. Registry data from the European Liver Transplant Registry regarding all first transplants for PSC between 1980 and 2015 were supplemented with detailed data on rPSC from 48 out of 138 contributing transplant centres, involving 1,549 patients. Bayesian proportional hazards models were used to investigate the impact of rPSC and other covariates on patient and graft survival. Recurrence of PSC was diagnosed in 259 patients (16.7%) after a median follow-up of 5.0 years (quantile 2.5%-97.5%: 0.4-18.5), with a significant negative impact on both graft (HR 6.7; 95% CI 4.9-9.1) and patient survival (HR 2.3; 95% CI 1.5-3.3). Patients with rPSC underwent significantly more re-transplants than those without rPSC (OR 3.6, 95% CI 2.7-4.8). PSC recurrence has a negative impact on both graft and patient survival, independent of transplant-related covariates. Recurrence of PSC leads to higher number of re-transplantations and a 33% decrease in 10-year graft survival.

    Originele taal-2English
    Pagina's (van-tot)1455-1467
    Aantal pagina's13
    TijdschriftTransplant International
    Volume34
    Nummer van het tijdschrift8
    DOI's
    StatusPublished - aug.-2021

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