Characteristics, Trends, and Outcomes of Liver Transplantation for Primary Sclerosing Cholangitis in Female Versus Male Patients: An Analysis from the European Liver Transplant Registry

Marina Berenguer*, Tommaso Di Maira, Ulrich Baumann, Darius F. Mirza, Michael A. Heneghan, Jurgen L. Klempnauer, William Bennet, Bo Goran Ericzon, Pål Dag Line, Peter A. Lodge, Krzysztof Zieniewicz, Christopher J.E. Watson, Herold J. Metselaar, René Adam, Vincent Karam, Victoria Aguilera

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)2255-2262
Number of pages8
JournalTransplantation
Volume105
Issue number10
DOIs
Publication statusPublished - Oct 2021

Bibliographical note

ACKNOWLEDGMENTS:
The authors thank all the centers who contribute to the
ELTR. The Organ Sharing Organizations the French
ABM (Sami Djabbour), the Dutch NTS (Maaike de
Wolf), the Eurotransplant Foundation (Marieke Van
Meel), the Spanish RETH (Gloria de la Rosa), the United
Kingdom–Ireland NHSBT (Michael Daynes), and the
Scandiatransplant (Ilse Duus Weinreich) are acknowledged
for the data cross-check and sharing with the ELTR.

Publisher Copyright: © 2021 Lippincott Williams and Wilkins. All rights reserved.

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