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  • 1 Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
  • 2 2nd Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
  • 3 Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary
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Abstract

Introduction

Recurrence of primary sclerosing cholangitis (rPSC) after liver transplantation (OLT) significantly affects longterm graft survival. We aimed to evaluate the incidence of rPSC and clinical data of these patients in Hungary.

Patients and Methods

We retrospectively analyzed data of 511 whole liver transplantations from 1995 to 2011. During the study period, 49 OLTs were performed in 43 adult patients with end-stage PSC (10%).

Results

Out of 49 OLT, 24 cases were excluded, rPSC was diagnosed in six patients (12%). Patients with rPSC had significantly higher mortality (p = 0.009) and graft loss (p = 0.009) in comparison to patients without recurrent disease. Younger recipient age, higher donor BMI was observed in the rPSC group. One patient was diagnosed with de novo IBD, the remaining five patients had worsening IBD activity in the posttransplant period. PreOLT colectomy was performed in 21% of the control and none of the rPSC group. PostOLT colectomy was performed in two rPSC patients due to severe therapy resistant colitis.

Conclusions

Recurrent PSC significantly affects long-term mortality and graft loss. Younger age at OLT, higher donor BMI and severe active IBD may be associated with PSC recurrence. PreOLT total colectomy might have protective effect against rPSC.

  • 1. J. Campsen M.A. Zimmerman J.F. Trotter M. Wachs T. Bak T. Steinberg I. Kam 2008 Clinically recurrent primary sclerosing cholangitis following liver transplantation: A time course Liver Transpl 14 181 185.

    • Search Google Scholar
    • Export Citation
  • 2. B. Fosby T.H. Karlsen E. Melum 2012 Recurrence and rejection in liver transplantation for primary sclerosing cholangitis World J Gastroenterol 18 1 1 15.

    • Search Google Scholar
    • Export Citation
  • 3. I.W. Graziadei R.H. Wiesner K.P. Batts P.J. Marotta N.F. LaRusso M.K. Porayko J.E. Hay G.J. Gores M.R. Charlton J. Ludwig J.J. Poterucha J.L. Steers R.A. Krom 1999 Recurrence of primary sclerosing cholangitis following liver transplantation Hepatology 29 4 1050 1056.

    • Search Google Scholar
    • Export Citation
  • 4. A. Vera S. Moledina B. Gunson S. Hubscher D. Mirza S. Olliff J. Neuberger 2002 Risk factors for recurrence of primary sclerosing cholangitis of liver allograft Lancet 360 1943 1944.

    • Search Google Scholar
    • Export Citation
  • 5. U. Khettry A. Keaveny A. Goldar-Najafi W.D. Lewis E.A. Pomfret J.J. Pomposelli R.L. Jenkins F.D. Gordon 2003 Liver transplantation for primary sclerosing cholangitis: a long-term clinicopathologic study Hum Pathol 34 1127 1136.

    • Search Google Scholar
    • Export Citation
  • 6. E. Alabraba P. Nightingale B. Gunson S. Hubscher S. Olliff D. Mirza J. Neuberger 2009 A re-evaluation of the risk factors for the recurrence of primary sclerosing cholangitis in liver allografts Liver Transpl 15 330 340.

    • Search Google Scholar
    • Export Citation
  • 7. F. Gelley P. Miheller A. Péter G. Telkes B. Nemes 2012 Activity of ulcerative colitis before and after liver transplantation in primary sclerosing cholangitis: The Hungarian experience Transplant Proc 44 7 2164 2165.

    • Search Google Scholar
    • Export Citation
  • 8. T.H. Karlsen E. Schrumpf K.M. Boberg 2010 Update on primary sclerosing cholangitis Dig Liver Dis 42 390 400.

  • 9. U. Oldakowska-Jedynak M. Nowak K. Mucha B. Foroncewicz P. Nyckowski K. Zieniewicz B. Ziarkiewicz-Wróblewska W. Patkowski B. Górnicka A. Paczkowska B. Michalowicz T. Pilecki J. Pawlak M. Krawczyk L. Paczek 2006 Recurrence of primary sclerosing cholangitis in patients after liver transplantation Transplant Proc 38 240 243.

    • Search Google Scholar
    • Export Citation
  • 10. D.H. Adams B. Eksteen S.M. Curbishley 2008 Immunology of the gut and the liver: a love/hate relationship Gut 57 838 848.

  • Medicine (miscellaneous) SJR Quartile Score (2018): Q3
  • Scimago Journal Rank (2018): 0.228
  • SJR Hirsch-Index (2018): 11

Language: English

Founded in 2008
Publication: One volume of four issues annually
Publication Programme: 2020. Vol. 12.

Publishing Model: Open Access with no author fee

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Senior editors

Editor(s)-in-Chief: Ágoston Szél

Vice Editor(s)-in-Chief: János Gál

Vice Editor(s)-in-Chief: Kálmán Hüttl

Vice Editor(s)-in-Chief: Béla Merkely

Chair of the Editorial Board: Balázs Hauser

Editorial Board

  • Miklós Antal (University of Debrecen, Hungary)
  • Enrico Calzia (Universitätsklinikum Ulm, Germany)
  • Zoltán Csanádi (University of Debrecen, Hungary)
  • Attila Doros (Semmelweis University, Hungary)
  • Edit Dósa (Semmelweis University, Hungary)
  • Dariusz Dudek (Jagiellonian University, Poland)
  • Susumu Eguchi (Nagasaki University, Japan)
  • László Entz (Semmelweis University, Hungary)
  • Nagy A. Habib (Imperial College London, UK)
  • Balázs Hauser (Semmelweis University, Hungary)
  • Miklós D. Kertai (Duke University, USA)
  • András Komócsi (University of Pécs, Hungary)
  • Karl-Heinz Kuck (Asklepios Klinik St. Georg, Germany)
  • Pal Maurovich-Horvat (Semmelweis University, Hungary)
  • Péter Metzger (Danube Hospital/SMZ-Ost, Austria)
  • László Miskolczi (University of Miami, USA)
  • Balázs Nemes (University of Debrecen, Hungary)
  • Attila Oláh (Petz Aladár County and Teaching Hospital, Hungary)
  • Wojciech G. Polak (Erasmus Medical Center, The Netherlands)
  • Robert Reisch (Clinic Hirslanden Zurich, Switzerland)
  • Bernhard Riedel (Vanderbilt University Medical Center, USA)
  • David Royston (Harefield Hospital, UK)
  • Thomas A. Sos (New York Presbyterian Hospital, USA)
  • Wolfgang Trubel (Privatklinik Doebling, Austria)

Semmelweis University. Institute of Human Morphology and Developmental Biology
Address: Tűzoltó u. 58. H-1094 Budapest, Hungary
E-mail: szel@ana2.sote.hu

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