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Recurrence of primary sclerosing cholangitis after liver transplantation - analysing the European Liver Transplant Registry and beyond
T. Visseren, NS. Erler, WG. Polak, R. Adam, V. Karam, FWR. Vondran, BG. Ericzon, D. Thorburn, JNM. IJzermans, A. Paul, F. van der Heide, P. Taimr, P. Nemec, J. Pirenne, R. Romagnoli, HJ. Metselaar, S. Darwish Murad, European Liver and Intestine...
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články
NLK
Medline Complete (EBSCOhost)
od 2004-05-01
Wiley Free Content
od 1997 do 2021
ROAD: Directory of Open Access Scholarly Resources
od 1988
PubMed
34028110
DOI
10.1111/tri.13925
Knihovny.cz E-zdroje
- MeSH
- Bayesova věta MeSH
- lidé MeSH
- recidiva MeSH
- registrace MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- sklerozující cholangitida * chirurgie MeSH
- transplantace jater * škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
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.
Abdominal Transplantation Surgery University Hospitals Leuven Leuven Belgium
Centre Hépatobiliaire AP HP Hôpital Paul Brousse Université Paris Saclay Villejuif France
Centre of Cardiovascular Surgery and Transplantations Brno Czech Republic
Department of Biostatistics Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
Department of Epidemiology Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
Department of General and Transplant Surgery University Hospital Essen Essen Germany
Department of General Visceral and Transplant Surgery Hannover Medical School Hannover Germany
Department of Hepatogastroenterology Institut Klinické Experimentální Medicíny Prague Czech Republic
Division of Transplantation Surgery Karolinska University Hospital Stockholm Sweden
Citace poskytuje Crossref.org
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- $a Visseren, Thijmen $u Department of Gastroenterology and Hepatology, Erasmus MC Transplant Institute, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands $u Department of Surgery, Division of Hepatopancreaticobiliary and Transplant Surgery, Erasmus MC Transplant Institute, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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- $a 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.
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