Patients with primary sclerosing cholangitis with and without end-stage liver disease have similar outcomes after liver transplantation

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064190%3A_____%2F26%3A10001441" target="_blank" >RIV/00064190:_____/26:10001441 - isvavai.cz</a>

Výsledek na webu

<a href="https://doi.org/10.4254/wjh.v18.i3.112934" target="_blank" >https://doi.org/10.4254/wjh.v18.i3.112934</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.4254/wjh.v18.i3.112934" target="_blank" >10.4254/wjh.v18.i3.112934</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Patients with primary sclerosing cholangitis with and without end-stage liver disease have similar outcomes after liver transplantation

Popis výsledku v původním jazyce

BACKGROUND Liver transplantation (LT) is the most effective treatment for the advanced stages of primary sclerosing cholangitis (PSC). However, up to 30% of patients develop recurrence of PSC (rPSC), which negatively affects graft and patient outcomes. Given the heterogeneous nature of PSC, patients undergo LT either due to end-stage liver disease (ESLD) or to symptoms that significantly reduce quality of life (non-ESLD), such as recurrent bacterial cholangitis or refractory pruritus. However, it remains unclear whether these indicators influence post-LT outcomes. AIM To compare post-LT outcomes between PSC recipients with ESLD and non-ESLD indications, and identify rPSC and graft failure risk factors. METHODS This single-center retrospective study comprised 131 adult LT recipients for PSC (including PSC/autoimmune overlap). Patients were grouped by listing indication for comparison of ESLD vs non-ESLD. ESLD was defined as model for ESLD score &gt;= 15 and Child-Pugh score &gt;= 8, or &gt;= 1 sign of decompensated cirrhosis. Time-to-event outcomes were analyzed using Kaplan-Meier and Cox models with time-updated covariates. RESULTS No significant difference was found in the incidence of rPSC, graft survival, or overall survival between patients indicated for LT for ESLD and those with non-advanced symptomatic disease. Cytomegalovirus infection (hazard ratio [HR] = 2.16; 95% confidence interval [CI]: 1.05-4.46), acute cellular rejection (ACR) (HR = 3.95; 95%CI: 1.44-10.8), and length of hospitalization after LT (HR = 1.02; 95%CI: 1.01-1.04) were significantly associated with risk of rPSC. In addition, multiple episodes of ACR (HR = 4.93; 95%CI: 1.22-19.9) and the length of hospitalization after LT (HR = 1.04; 95%CI: 1.01-1.06) were significantly associated with graft failure. CONCLUSION Patients with PSC with advanced liver cirrhosis before LT did not have worse post-transplant outcomes than those without ESLD. Cytomegalovirus infection, ACR, and prolonged hospitalization after LT were associated with worse outcomes after LT in PSC.

Název v anglickém jazyce

Patients with primary sclerosing cholangitis with and without end-stage liver disease have similar outcomes after liver transplantation

Popis výsledku anglicky

BACKGROUND Liver transplantation (LT) is the most effective treatment for the advanced stages of primary sclerosing cholangitis (PSC). However, up to 30% of patients develop recurrence of PSC (rPSC), which negatively affects graft and patient outcomes. Given the heterogeneous nature of PSC, patients undergo LT either due to end-stage liver disease (ESLD) or to symptoms that significantly reduce quality of life (non-ESLD), such as recurrent bacterial cholangitis or refractory pruritus. However, it remains unclear whether these indicators influence post-LT outcomes. AIM To compare post-LT outcomes between PSC recipients with ESLD and non-ESLD indications, and identify rPSC and graft failure risk factors. METHODS This single-center retrospective study comprised 131 adult LT recipients for PSC (including PSC/autoimmune overlap). Patients were grouped by listing indication for comparison of ESLD vs non-ESLD. ESLD was defined as model for ESLD score &gt;= 15 and Child-Pugh score &gt;= 8, or &gt;= 1 sign of decompensated cirrhosis. Time-to-event outcomes were analyzed using Kaplan-Meier and Cox models with time-updated covariates. RESULTS No significant difference was found in the incidence of rPSC, graft survival, or overall survival between patients indicated for LT for ESLD and those with non-advanced symptomatic disease. Cytomegalovirus infection (hazard ratio [HR] = 2.16; 95% confidence interval [CI]: 1.05-4.46), acute cellular rejection (ACR) (HR = 3.95; 95%CI: 1.44-10.8), and length of hospitalization after LT (HR = 1.02; 95%CI: 1.01-1.04) were significantly associated with risk of rPSC. In addition, multiple episodes of ACR (HR = 4.93; 95%CI: 1.22-19.9) and the length of hospitalization after LT (HR = 1.04; 95%CI: 1.01-1.06) were significantly associated with graft failure. CONCLUSION Patients with PSC with advanced liver cirrhosis before LT did not have worse post-transplant outcomes than those without ESLD. Cytomegalovirus infection, ACR, and prolonged hospitalization after LT were associated with worse outcomes after LT in PSC.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30219 - Gastroenterology and hepatology

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2026

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

World Journal of Hepatology

ISSN

1948-5182

e-ISSN

—

Svazek periodika

18

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

12

Strana od-do

nestránkováno

Kód UT WoS článku

001732559500007

EID výsledku v databázi Scopus

2-s2.0-105037580808