Comparing risk factors for recurrent PSC in living and deceased donor recipients

People with Primary Sclerosing Cholangitis (PSC) experience severe liver damage, for which the only known cure is a liver transplant. After a liver transplant, PSC returns in 15 to 25 percent of patients.

In a new study published in Liver Transplantation, investigators from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) identified several risk factors for PSC recurrence. Time-dependent onset of a biliary complication, higher Model for End-Stage Liver Disease (MELD) scores at transplant, higher donor age, and the presence of pre-transplant cholangiocarcinoma had statistically significant associations with higher risk of PSC recurrence.

“The risk factors that we identified will provide transplant centers with ways to potentially influence and improve live donor choices for PSC patients,” said lead author Dr. Fredric D. Gordon. The authors advise that transplant centers should address modifiable pre-transplant variables, including transplantation at lower MELD scores and younger donor age, both of which may be controllable with living liver donors.

The authors also compared the risk of PSC recurrence in living donor versus deceased donor recipients. They found that the overall risk of PSC recurrence was 8.7 percent five years after transplantation and 22.4 percent ten years after transplantation. The risk of PSC recurrence was not significantly different for living donor liver transplant versus deceased donor liver transplant.

CITATION:Gordon FD, Goldberg DS, Goodrich NP, Lok ASF, Verna EC, Selzner N, Stravitz RT, Merion RM. Recurrent primary sclerosing cholangitis in the Adult to Adult Living Donor Liver Transplantation Cohort Study: Comparison of risk factors between living and deceased donor recipients. Liver Transpl 2016;22(9):1214-1222.
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