Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis

Antonio Molinaro; Lise Katrine Engesæter; Carl Jorns; Arno Nordin; Allan Rasmussen; Pål-Dag Line; Virge Pall; Bo-Göran Ericzon; William Bennet; Johannes R Hov; Espen Melum

doi:10.1111/liv.16214

Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis

Antonio Molinaro, Lise Katrine Engesæter, Carl Jorns, Arno Nordin, Allan Rasmussen, Pål-Dag Line, Virge Pall, Bo-Göran Ericzon, William Bennet, Johannes R Hov, Espen Melum^*

^*Corresponding author af dette arbejde

Afdeling for Transplantation og Sygdomme i Fordøjelsessystemet

Abstract

BACKGROUND AND AIMS: Primary sclerosing cholangitis (PSC) is among the most common indications for liver transplantation in the Nordic countries and with an increasing trend in Europe and North America. Due to post-transplant complications and high prevalence of disease recurrence this group is at risk of requiring retransplantation (re-LTX). Results from re-LTX for PSC are not extensively studied and there is a lack of knowledge regarding prognosis after re-LTX in this population.

METHODS: Graft and patient survival after re-LTX for patients with PSC and a comparable comparison group from the Nordic liver transplant registry were analysed. One-hundred and eighty-five patients with PSC and 208 patients in the comparison group were included.

RESULTS: The graft and patient survival were better for patients with PSC compared to the comparison group (p < 0.001). Re-LTX for recurrence of PSC (rPSC) compared to other aetiologies had similar and better outcomes for graft and patient survival (p = 0.093 and p = 0.023, respectively). Moreover, re-LTX for rPSC compared to the comparison group had a lower 30-day and 5-year mortality (p < 0.001 and p = 0.041, respectively).

CONCLUSION: Outcomes after retransplantation for PSC were similar or better compared to the comparison group. Retransplantation represents a treatment option with the potential for excellent outcomes in patients with PSC and should be considered in transplanted PSC patients with graft failure.

Originalsprog	Engelsk
Artikelnummer	e16214
Tidsskrift	Liver international : official journal of the International Association for the Study of the Liver
Vol/bind	45
Udgave nummer	1
ISSN	1478-3223
DOI	https://doi.org/10.1111/liv.16214
Status	Udgivet - jan. 2025

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10.1111/liv.16214Licens: CC BY-NC

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Molinaro, A., Engesæter, L. K., Jorns, C., Nordin, A., Rasmussen, A., Line, P.-D., Pall, V., Ericzon, B.-G., Bennet, W., Hov, J. R., & Melum, E. (2025). Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis. Liver international : official journal of the International Association for the Study of the Liver, 45(1), Artikel e16214. https://doi.org/10.1111/liv.16214

Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis. / Molinaro, Antonio; Engesæter, Lise Katrine; Jorns, Carl et al.
I: Liver international : official journal of the International Association for the Study of the Liver, Bind 45, Nr. 1, e16214, 01.2025.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Molinaro, A, Engesæter, LK, Jorns, C, Nordin, A, Rasmussen, A, Line, P-D, Pall, V, Ericzon, B-G, Bennet, W, Hov, JR & Melum, E 2025, 'Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis', Liver international : official journal of the International Association for the Study of the Liver, bind 45, nr. 1, e16214. https://doi.org/10.1111/liv.16214

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title = "Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis",

abstract = "BACKGROUND AND AIMS: Primary sclerosing cholangitis (PSC) is among the most common indications for liver transplantation in the Nordic countries and with an increasing trend in Europe and North America. Due to post-transplant complications and high prevalence of disease recurrence this group is at risk of requiring retransplantation (re-LTX). Results from re-LTX for PSC are not extensively studied and there is a lack of knowledge regarding prognosis after re-LTX in this population.METHODS: Graft and patient survival after re-LTX for patients with PSC and a comparable comparison group from the Nordic liver transplant registry were analysed. One-hundred and eighty-five patients with PSC and 208 patients in the comparison group were included.RESULTS: The graft and patient survival were better for patients with PSC compared to the comparison group (p < 0.001). Re-LTX for recurrence of PSC (rPSC) compared to other aetiologies had similar and better outcomes for graft and patient survival (p = 0.093 and p = 0.023, respectively). Moreover, re-LTX for rPSC compared to the comparison group had a lower 30-day and 5-year mortality (p < 0.001 and p = 0.041, respectively).CONCLUSION: Outcomes after retransplantation for PSC were similar or better compared to the comparison group. Retransplantation represents a treatment option with the potential for excellent outcomes in patients with PSC and should be considered in transplanted PSC patients with graft failure.",

keywords = "Humans, Cholangitis, Sclerosing/surgery, Liver Transplantation/adverse effects, Reoperation, Male, Female, Graft Survival, Recurrence, Adult, Middle Aged, Treatment Outcome, Registries, Scandinavian and Nordic Countries/epidemiology, Retrospective Studies, retransplantation, liver transplantation, primary sclerosing cholangitis",

author = "Antonio Molinaro and Enges{\ae}ter, {Lise Katrine} and Carl Jorns and Arno Nordin and Allan Rasmussen and P{\aa}l-Dag Line and Virge Pall and Bo-G{\"o}ran Ericzon and William Bennet and Hov, {Johannes R} and Espen Melum",

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year = "2025",

month = jan,

doi = "10.1111/liv.16214",

language = "English",

volume = "45",

journal = "Liver international : official journal of the International Association for the Study of the Liver",

issn = "1478-3223",

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T1 - Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis

AU - Molinaro, Antonio

AU - Engesæter, Lise Katrine

AU - Jorns, Carl

AU - Nordin, Arno

AU - Rasmussen, Allan

AU - Line, Pål-Dag

AU - Pall, Virge

AU - Ericzon, Bo-Göran

AU - Bennet, William

AU - Hov, Johannes R

AU - Melum, Espen

PY - 2025/1

Y1 - 2025/1

N2 - BACKGROUND AND AIMS: Primary sclerosing cholangitis (PSC) is among the most common indications for liver transplantation in the Nordic countries and with an increasing trend in Europe and North America. Due to post-transplant complications and high prevalence of disease recurrence this group is at risk of requiring retransplantation (re-LTX). Results from re-LTX for PSC are not extensively studied and there is a lack of knowledge regarding prognosis after re-LTX in this population.METHODS: Graft and patient survival after re-LTX for patients with PSC and a comparable comparison group from the Nordic liver transplant registry were analysed. One-hundred and eighty-five patients with PSC and 208 patients in the comparison group were included.RESULTS: The graft and patient survival were better for patients with PSC compared to the comparison group (p < 0.001). Re-LTX for recurrence of PSC (rPSC) compared to other aetiologies had similar and better outcomes for graft and patient survival (p = 0.093 and p = 0.023, respectively). Moreover, re-LTX for rPSC compared to the comparison group had a lower 30-day and 5-year mortality (p < 0.001 and p = 0.041, respectively).CONCLUSION: Outcomes after retransplantation for PSC were similar or better compared to the comparison group. Retransplantation represents a treatment option with the potential for excellent outcomes in patients with PSC and should be considered in transplanted PSC patients with graft failure.

AB - BACKGROUND AND AIMS: Primary sclerosing cholangitis (PSC) is among the most common indications for liver transplantation in the Nordic countries and with an increasing trend in Europe and North America. Due to post-transplant complications and high prevalence of disease recurrence this group is at risk of requiring retransplantation (re-LTX). Results from re-LTX for PSC are not extensively studied and there is a lack of knowledge regarding prognosis after re-LTX in this population.METHODS: Graft and patient survival after re-LTX for patients with PSC and a comparable comparison group from the Nordic liver transplant registry were analysed. One-hundred and eighty-five patients with PSC and 208 patients in the comparison group were included.RESULTS: The graft and patient survival were better for patients with PSC compared to the comparison group (p < 0.001). Re-LTX for recurrence of PSC (rPSC) compared to other aetiologies had similar and better outcomes for graft and patient survival (p = 0.093 and p = 0.023, respectively). Moreover, re-LTX for rPSC compared to the comparison group had a lower 30-day and 5-year mortality (p < 0.001 and p = 0.041, respectively).CONCLUSION: Outcomes after retransplantation for PSC were similar or better compared to the comparison group. Retransplantation represents a treatment option with the potential for excellent outcomes in patients with PSC and should be considered in transplanted PSC patients with graft failure.

KW - Humans

KW - Cholangitis, Sclerosing/surgery

KW - Liver Transplantation/adverse effects

KW - Reoperation

KW - Male

KW - Female

KW - Graft Survival

KW - Recurrence

KW - Adult

KW - Middle Aged

KW - Treatment Outcome

KW - Registries

KW - Scandinavian and Nordic Countries/epidemiology

KW - Retrospective Studies

KW - retransplantation

KW - liver transplantation

KW - primary sclerosing cholangitis

UR - http://www.scopus.com/inward/record.url?scp=85212154359&partnerID=8YFLogxK

U2 - 10.1111/liv.16214

DO - 10.1111/liv.16214

M3 - Journal article

C2 - 39679639

SN - 1478-3223

VL - 45

JO - Liver international : official journal of the International Association for the Study of the Liver

JF - Liver international : official journal of the International Association for the Study of the Liver

IS - 1

M1 - e16214

ER -

Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis

Abstract

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