[en] 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.
Disciplines :
Surgery Gastroenterology & hepatology
Author, co-author :
Visseren, Thijmen ; Department of Gastroenterology and Hepatology, Erasmus MC Transplant Institute, ; Department of Surgery, Division of Hepatopancreaticobiliary and Transplant Surgery
Erler, Nicole Stephanie; Department of Biostatistics, Erasmus MC University Medical Center Rotterdam, ; Department of Epidemiology, Erasmus MC University Medical Center Rotterdam,
Polak, Wojciech Grzegorz ; Department of Surgery, Division of Hepatopancreaticobiliary and Transplant Surgery
Adam, René; Centre Hépatobiliaire, AP-HP Hôpital Paul Brousse, Université Paris-Saclay,
Karam, Vincent ; Centre Hépatobiliaire, AP-HP Hôpital Paul Brousse, Université Paris-Saclay
Vondran, Florian Wolfgang Rudolf; Department of General, Visceral and Transplant Surgery, Hannover Medical School,
Ericzon, Bo-Goran; Division of Transplantation Surgery, Karolinska University Hospital, Stockholm,
Thorburn, Douglas; Sheila Sherlock Liver Centre and UCL Institute of Liver and Digestive Health, Royal
IJzermans, Jan Nicolaas Maria; Department of Surgery, Division of Hepatopancreaticobiliary and Transplant Surgery,
Paul, Andreas; Department of General and Transplant Surgery, University Hospital Essen, Essen,
van der Heide, Frans; Department of Gastroenterology and Hepatology, University of Groningen and
Taimr, Pavel; Department of Hepatogastroenterology, Institut Klinické Experimentální Medicíny,
Nemec, Petr; Centre of Cardiovascular Surgery and Transplantations, Brno, Czech Republic.
Pirenne, Jacques ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgie abdominale ; Abdominal Transplantation Surgery, University Hospitals Leuven, Leuven, Belgium.
Romagnoli, Renato ; Liver Transplantation Center, Azienda Ospedaliero-Universitaria, Città della Salute
Metselaar, Herold Johnny ; Department of Gastroenterology and Hepatology, Erasmus MC Transplant Institute
Darwish Murad, Sarwa ; Department of Gastroenterology and Hepatology, Erasmus MC Transplant Institute
European Liver and Intestine Transplantation Association, ( E L I T A)
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