Characteristics, trends, and outcomes of liver transplantation for primary sclerosing cholangitis in female versus male patients: an analysis from the European Liver Transplant Registry
Berenguer, Marina Di Maira, Tommaso Baumann, Ulrich Mirza, Darius F Heneghan, Michael A Klempnauer, Jurgen L Bennet, William Ericzon, Bo-Goran Line, Pål-Dag Lodge, Peter A
Berenguer, Marina
Di Maira, Tommaso
Baumann, Ulrich
Mirza, Darius F
Heneghan, Michael A
Klempnauer, Jurgen L
Bennet, William
Ericzon, Bo-Goran
Line, Pål-Dag
Lodge, Peter A
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2021-10-01
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Abstract
Background: The influence of sex on primary sclerosing cholangitis (PSC), pre- and postliver transplantation (LT) is unclear. Aims are to assess whether there have been changes in incidence, profile, and outcome in LT-PSC patients in Europe with specific emphasis on sex.
Methods: Analysis of the European Liver Transplant Registry database (PSC patients registered before 2018), including baseline demographics, donor, biochemical, and clinical data at LT, immunosuppression, and outcome.
Results: European Liver Transplant Registry analysis (n = 6463, 32% female individuals) demonstrated an increasing number by cohort (1980-1989, n = 159; 1990-1999, n = 1282; 2000-2009, n = 2316; 2010-2017, n = 2549) representing on average 4% of all transplant indications. This increase was more pronounced in women (from 1.8% in the first cohort to 4.3% in the last cohort). Graft survival rate at 1, 5, 10, 15, 20, and 30 y was 83.6%, 70.8%, 57.7%, 44.9%, 30.8%, and 11.6%, respectively. Variables independently associated with worse survival were male sex, donor and recipient age, cholangiocarcinoma at LT, nondonation after brain death donor, and reduced size of the graft. These findings were confirmed using a more recent LT population closer to the current standard of care (LT after the y 2000).
Conclusions: An increasing number of PSC patients, particularly women, are being transplanted in European countries with better graft outcomes in female recipients. Other variables impacting outcome include donor and recipient age, cholangiocarcinoma, nondonation after brain death donor, and reduced graft size.
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Berenguer M, Di Maira T, Baumann U, Mirza DF, Heneghan MA, Klempnauer JL, Bennet W, Ericzon BG, Line PD, Lodge PA, Zieniewicz K, Watson CJE, Metselaar HJ, Adam R, Karam V, Aguilera V; all the other contributing centers (www.eltr.org) and the European Liver and Intestine Transplant Association (ELITA). Characteristics, Trends, and Outcomes of Liver Transplantation for Primary Sclerosing Cholangitis in Female Versus Male Patients: An Analysis From the European Liver Transplant Registry. Transplantation. 2021 Oct 1;105(10):2255-2262. doi: 10.1097/TP.0000000000003542
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Article