دورية أكاديمية
Prognostic scores for ursodeoxycholic acid-treated patients predict graft loss and mortality in recurrent primary biliary cholangitis after liver transplantation.
| العنوان: | Prognostic scores for ursodeoxycholic acid-treated patients predict graft loss and mortality in recurrent primary biliary cholangitis after liver transplantation. |
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| المؤلفون: | Montano-Loza AJ; University of Alberta, Edmonton, Alberta, Canada. Electronic address: montanol@ualberta.ca., Lytvyak E; University of Alberta, Edmonton, Alberta, Canada., Hirschfield G; Toronto Center for Liver Disease, UHN, Toronto, Canada., Hansen BE; Dept of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; IHPME, University of Toronto & Toronto Center for Liver Disease, UHN, Toronto, Canada., Ebadi M; University of Alberta, Edmonton, Alberta, Canada., Berney T; Geneva University Hospitals, Geneva, Switzerland., Toso C; Geneva University Hospitals, Geneva, Switzerland., Magini G; Geneva University Hospitals, Geneva, Switzerland., Villamil A; Unidad de Autoinmunidad Hepática, Sección de Hepatología y Trasplante Hepático, Hospital Italiano de Buenos Aires, Argentina., Nevens F; Division Liver and Biliopancreatic Disorders, Leuven, Belgium., Van den Ende N; Division Liver and Biliopancreatic Disorders, Leuven, Belgium., Pares A; University of Barcelona, Barcelona, Spain., Ruiz P; Liver Unit, Hospital Clínic, Barcelona, Spain., Terrabuio D; University of São Paulo School of Medicine, San Paulo, Brazil., Trivedi PJ; University of Birmingham, Birmingham, United Kingdom., Abbas N; University of Birmingham, Birmingham, United Kingdom., Donato MF; Division of Gastroenterology and Hepatology, Fondazione IRCCS Maggiore Hospital Policlinico Milan, Italy., Yu L; University of Washington, Seattle, USA., Landis C; University of Washington, Seattle, USA., Dumortier J; Hospices civils de Lyon, Edouard Herriot Hospital Hepatogastroenterology Unit, and University of Lyon, Lyon, France., Dyson JK; Newcastle University, Newcastle, United Kingdom., van der Meer AJ; Dept of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, Netherlands., de Veer R; Dept of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, Netherlands., Pedersen M; University of Texas Southwestern Medical Center, Dallas, USA., Mayo M; University of Texas Southwestern Medical Center, Dallas, USA., Manns MP; Hannover Medical School, Hannover, Germany., Taubert R; Dept. Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany., Kirchner T; Dept. Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany., Belli LS; Niguarda transplant centre, Milan, Italy., Mazzarelli C; Niguarda transplant centre, Milan, Italy., Stirnimann G; University Hospital Inselspital, Bern, Switzerland., Floreani A; University of Padova, Padova, Italy., Cazzagon N; University of Padova, Padova, Italy., Russo FP; University of Padova, Padova, Italy., Burra P; University of Padova, Padova, Italy., Zigmound U; Tel Aviv Medical Centre, Tel Aviv, Israel., Houri I; Tel Aviv Medical Centre, Tel Aviv, Israel., Carbone M; University of Milano-Bicocca, Milan, Italy., Mulinacci G; University of Milano-Bicocca, Milan, Italy., Fagiuoli S; Gastroenterology Hepatology and Transplantation UNIT, ASST Papa Giovanni XXIII, Bergamo & Department of Medicine, University of Milano-Bicocca, Milan, Italy., Pratt DS; Massachusetts General Hospital, Harvard Medical School, Boston, USA., Bonder A; Liver Center, Beth Israel Deaconess Medical Center, Department of Internal Medicine, Harvard Medical School, Boston, MA, USA., Schiano TD; Mount Sinai Medical Center, New York, USA., Haydel B; Mount Sinai Medical Center, New York, USA., Lohse A; University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Schramm C; Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Germany., Rüther D; University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Casu S; INSELSPITAL, Universitätsspital Bern, Switzerland., Verhelst X; Ghent University Hospital, Ghent, Belgium., Beretta-Piccoli BT; Epatocentro Ticino, Lugano, Switzerland., Robles M; University Hospital Virgen de la Victoria, Málaga, Spain., Mason AL; University of Alberta, Edmonton, Alberta, Canada., Corpechot C; Reference centre for inflammatory biliary diseases and auto-immune hepatitis, Saint-Antoine Hospital, Paris, France. |
| مؤلفون مشاركون: | Global PBC Study Group |
| المصدر: | Journal of hepatology [J Hepatol] 2024 May 29. Date of Electronic Publication: 2024 May 29. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8503886 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1600-0641 (Electronic) Linking ISSN: 01688278 NLM ISO Abbreviation: J Hepatol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2001- : Amsterdam : Elsevier Original Publication: Copehnagen : Munksgaard International Publishers, [c1984- |
| مستخلص: | Background & Aims: Recurrent primary biliary cholangitis (rPBC) develops in approximately 30% of patients and negatively impacts graft and overall patient survival after liver transplantation (LT). There is a lack of data regarding the response rate to ursodeoxycholic acid (UDCA) in rPBC. We evaluated a large, international, multi-center cohort to assess the performance of PBC scores in predicting the risk of graft and overall survival after LT in patients with rPBC. Methods: A total of 332 patients with rPBC after LT were evaluated from 28 centers across Europe, North and South America. The median age at the time of rPBC was 58.0 years [IQR 53.2-62.6], and 298 patients (90%) were female. The biochemical response was measured with serum levels of alkaline phosphatase (ALP) and bilirubin, and Paris-2, GLOBE and UK-PBC scores at 1 year after UDCA initiation. Results: During a median follow-up of 8.7 years [IQR 4.3-12.9] after rPBC diagnosis, 52 patients (16%) had graft loss and 103 (31%) died. After 1 year of UDCA initiation the histological stage at rPBC (hazard ratio [HR] 3.97, 95% CI 1.36-11.55, p = 0.01), use of prednisone (HR 3.18, 95% CI 1.04-9.73, p = 0.04), ALP xULN (HR 1.59, 95% CI 1.26-2.01, p <0.001), Paris-2 criteria (HR 4.14, 95% CI 1.57-10.92, p = 0.004), GLOBE score (HR 2.82, 95% CI 1.71-4.66, p <0.001), and the UK-PBC score (HR 1.06, 95% CI 1.03-1.09, p <0.001) were associated with graft survival in the multivariate analysis. Similar results were observed for overall survival. Conclusion: Patients with rPBC and disease activity, as indicated by standard PBC risk scores, have impaired outcomes, supporting efforts to treat recurrent disease in similar ways to pre-transplant PBC. Impact and Implications: One in three people who undergo liver transplantation for primary biliary cholangitis develop recurrent disease in their new liver. Patients with recurrent primary biliary cholangitis and incomplete response to ursodeoxycholic acid, according to conventional prognostic scores, have worse clinical outcomes, with higher risk of graft loss and mortality in similar ways to the disease before liver transplantation. Our results supportsupport efforts to treat recurrent disease in similar ways to pre-transplant primary biliary cholangitis. (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: autoimmune liver disease; graft survival; liver transplantation; recurrent disease; survival |
| تواريخ الأحداث: | Date Created: 20240531 Latest Revision: 20240629 |
| رمز التحديث: | 20240630 |
| DOI: | 10.1016/j.jhep.2024.05.010 |
| PMID: | 38821360 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1600-0641 |
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| DOI: | 10.1016/j.jhep.2024.05.010 |