PMID- 18236405
OWN - NLM
STAT- MEDLINE
DCOM- 20080320
LR  - 20161124
IS  - 1527-6465 (Print)
IS  - 1527-6465 (Linking)
VI  - 14
IP  - 2
DP  - 2008 Feb
TI  - Risk factors for recurrence of primary sclerosing cholangitis after liver 
      transplantation.
PG  - 245-51
LID - 10.1002/lt.21394 [doi]
AB  - Orthotopic liver transplantation (OLT) is the only effective treatment for 
      end-stage liver disease due to primary sclerosing cholangitis (PSC). Recurrence 
      of PSC has recently emerged as a leading cause of allograft failure in the long 
      term. There is limited data on risk factors for recurrence of PSC. We performed a 
      retrospective analysis of 69 consecutive patients who underwent a first OLT for 
      PSC over a 14-year period. Baseline characteristics and clinical and laboratory 
      test results post-LT were recorded. Cholangiograms and liver histopathology were 
      reviewed in a blinded manner by an experienced radiologist and hepatopathologist. 
      Recurrent PSC was diagnosed using previously published Mayo Clinic 
      cholangiographic or histologic criteria. Of 69 patients, 7 (10%) developed 
      recurrent PSC at a median of 68 months (range, 24-134 months) post-LT. The 
      following variables were associated with recurrent PSC in our cohort: presence of 
      human leukocyte antigen (HLA)-DRB1*08 (29% versus 2%; P= 0.026; odds ratio [OR], 
      24.4; 95% confidence interval [CI], 1.8-318.1), acute cellular rejection (ACR) 
      (71% versus 22%; P= 0.015; OR, 8.7; 95% CI, 1.5-49.9), and steroid-resistant ACR 
      (29% versus 0%; P= 0.012). Despite the strong linkage disequilibrium between 
      DRB1*08 and DQB1*04, DRB1*08-positive subjects with recurrence were negative for 
      DQB1*04, whereas the single DRB1*08-positive subject without recurrent PSC was 
      positive for DQB1*04. A history of ACR and presence of HLA-DRB1*08 are associated 
      with increased risk of recurrent PSC, suggesting an immunologic mechanism for 
      this syndrome. Further studies are required to confirm these observations and to 
      understand the underlying mechanisms.
FAU - Alexander, Jacob
AU  - Alexander J
AD  - Division of Gastroenterology, Department of Medicine, University of Washington, 
      Seattle, WA, USA.
FAU - Lord, James D
AU  - Lord JD
FAU - Yeh, Matthew M
AU  - Yeh MM
FAU - Cuevas, Carlos
AU  - Cuevas C
FAU - Bakthavatsalam, Ramasamy
AU  - Bakthavatsalam R
FAU - Kowdley, Kris V
AU  - Kowdley KV
LA  - eng
GR  - DK-02957/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Liver Transpl
JT  - Liver transplantation : official publication of the American Association for the 
      Study of Liver Diseases and the International Liver Transplantation Society
JID - 100909185
RN  - 0 (HLA-DR Antigens)
RN  - 0 (HLA-DRB1 Chains)
SB  - IM
CIN - Liver Transpl. 2008 Feb;14(2):130-2. PMID: 18236444
MH  - Adult
MH  - Aged
MH  - Cholangiography
MH  - Cholangitis, Sclerosing/diagnostic imaging/genetics/immunology/mortality/*surgery
MH  - Disease-Free Survival
MH  - Female
MH  - Gene Frequency
MH  - Genetic Predisposition to Disease
MH  - Graft Rejection/complications
MH  - HLA-DR Antigens/genetics
MH  - HLA-DRB1 Chains
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - *Liver Transplantation
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Recurrence
MH  - Reoperation
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2008/02/01 09:00
MHDA- 2008/03/21 09:00
CRDT- 2008/02/01 09:00
PHST- 2008/02/01 09:00 [pubmed]
PHST- 2008/03/21 09:00 [medline]
PHST- 2008/02/01 09:00 [entrez]
AID - 10.1002/lt.21394 [doi]
PST - ppublish
SO  - Liver Transpl. 2008 Feb;14(2):245-51. doi: 10.1002/lt.21394.