Systematic review with meta-analysis: risk factors for recurrent primary sclerosing cholangitis after liver transplantation.

Steenstraten, Iris C and Sebib Korkmaz, Kerem and Trivedi, Palak J and Inderson, Akin and van Hoek, Bart and Rodriguez Girondo, Mar D M and Maljaars, P W Jeroen (2019) Systematic review with meta-analysis: risk factors for recurrent primary sclerosing cholangitis after liver transplantation. Alimentary pharmacology & therapeutics, 49 (6). pp. 636-643. ISSN 1365-2036. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://doi.org/10.1111/apt.15148

Abstract

BACKGROUND

After liver transplantation primary sclerosing cholangitis (PSC), the condition returns in the transplanted liver in a subset of patients (recurrent primary sclerosing cholangitis, rPSC).

AIM

To define risk factors for rPSC.

METHODS

We searched Pubmed, Embase, Web of Science, and Cochrane library for articles published until March 2018. Studies addressing risk factors for developing rPSC were eligible for inclusion. A random effects meta-analysis was conducted using hazard ratios (HR) as effect measure. Study quality was evaluated with the Newcastle Ottawa scale. Statistical analysis was performed using Cochrane Review Manager.

RESULTS

The electronic database search yielded 449 results. Twenty-one retrospective cohort studies met the inclusion criteria for the review; 14 were included in the meta-analysis. The final cohort included 2159 patients (age range 31-49 years, 68.8% male), of whom 17.7% developed rPSC. Colectomy before liver transplantation, HR 0.65 (95% CI: 0.42-0.99), cholangiocarcinoma before liver transplantation, HR 2.42 (95% CI: 1.20-4.86), inflammatory bowel disease, HR 1.73 (95% CI: 1.17-2.54), donor age, HR 1.24 (95% CI 1.0-1.45) per ten years, MELD score, HR 1.05 (95% CI: 1.02-1.08) per point and acute cellular rejection, HR of 1.94 (95% CI: 1.32-2.83) were associated with the risk of rPSC.

CONCLUSIONS

Multiple risk factors for rPSC were identified. Colectomy before liver transplantation reduced the risk of rPSC.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QW Microbiology. Immunology
WK Endocrine system. Endocrinology
Divisions: Emergency Services > Renal
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 18 Mar 2019 15:14
Last Modified: 18 Mar 2019 15:14
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1934

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