AIM: To evaluate risk factors for primary sclerosing cholangitis (PSC) recurrence (rPSC) after orthotopic liver transplantation (OLT) in patients with well-preserved colons. METHODS: We retrospectively evaluated the medical records of all patients transplanted for PSC in our center between July 1994 and May 2015 and selected 47 with follow-up of at least 60 mo for further analysis based on strict inclusion and exclusion criteria. rPSC was confirmed by magnetic resonance or endoscopic retrograde cholangiopancreatography and liver biopsy. All patients were evaluated by protocolary pre-OLT colonoscopy with randomized mucosal biopsies. Colonoscopy was repeated annually after OLT. Both organ donors and recipients were human leukocyte antigen (HLA) typed by serological and/or DNA methods. All input data were thoroughly analyzed employing relevant statistical methods. RESULTS: Altogether, 31 men and 16 women with a median (range) age of 36 (15-68) years at the time of OLT and a median follow-up of 122 (60-249) mo were included. rPSC was confirmed in 21/47 (44.7%) of patients, a median 63 (12-180) mo after transplantation. De novo colitis [rPSC in 11/12, P ≤ 0.05, hazard ratio (HR): 4.02, 95% confidence interval (CI): 1.58-10.98] and history of acute cellular rejection (rPSC in 14/25, P ≤ 0.05; HR: 2.66, 95%CI: 1.03-7.86) showed strong positive associations with rPSC. According to the univariate analysis, overlapping features of autoimmune hepatitis (rPSC in 5/5, P ≤ 0.05) and HLA-DRB1*07 in the donor (rPSC in 10/15, P ≤ 0.05) represent other potential risk factors for rPSC, while the HLA-DRB1*04 (rPSC in 0/6, P ≤ 0.05), HLA-DQB1*03 (rPSC in 1/11, P ≤ 0.05), and HLA-DQB1*07 (rPSC in 0/7, P ≤ 0.05) recipient alleles may have protective roles. CONCLUSION: De novo colitis and acute cellular rejection are clinical conditions significantly predisposed towards recurrence of PSC after liver transplantation.
- MeSH
- Cholangiopancreatography, Endoscopic Retrograde MeSH
- Tissue Donors statistics & numerical data MeSH
- Child MeSH
- Adult MeSH
- Risk Assessment methods MeSH
- Inflammatory Bowel Diseases diagnostic imaging epidemiology pathology MeSH
- Liver diagnostic imaging pathology MeSH
- Colon diagnostic imaging pathology MeSH
- Colonoscopy MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Adolescent MeSH
- Young Adult MeSH
- Follow-Up Studies MeSH
- Child, Preschool MeSH
- Recurrence MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Cholangitis, Sclerosing diagnostic imaging pathology surgery MeSH
- Intestinal Mucosa diagnostic imaging pathology MeSH
- Liver Transplantation * MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Child, Preschool MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Cholangiopancreatography, Endoscopic Retrograde methods instrumentation statistics & numerical data MeSH
- Endoscopy, Digestive System methods instrumentation statistics & numerical data MeSH
- Inflammatory Bowel Diseases diagnostic imaging MeSH
- Humans MeSH
- Cholangitis, Sclerosing * diagnostic imaging epidemiology therapy MeSH
- Check Tag
- Humans MeSH
