TBA (22W157)

PSC recurrence post Liver Transplantation

Author(s)

Sopena-Falco J; MacNicholas R; Iqbal M; El Sherif O; Dillon A; Galvin J; McCormick A

Department(s)/Institutions

Hepatology Unit, St. Vincent's University Hospital

Introduction

PSC accounts for 4% of total indications for liver transplantation (LT) in Europe and it has 70.8% graft survival after five years. Previous studies showed that between 10 to 28% of patients will develop recurrence of PSC (rPSC) within ten years. Multiple factors have previously been identified including donor related factors (donor age, graft quality), recipient related factors (colectomy before LT, cholangiocarcinoma as LT indication, MELD, presence of IBD) and post-transplant related factors (type of IS, presence and number of ACR episodes), etc.

Aims/Background

To assess the incidence of rPSC in an Irish cohort and its associated risk factors.

Method

Retrospective review of all first LT performed for PSC from 01 January 2000 until 31 June 2021. SPSS analysis

Results

124 patients were included in the study. 76.6% were male and mean age at LT was 48 (SD±12.9; 21-69). Indication for LT was in 40.3% decompensated cirrhosis, 16.1% CCA and 20.2% recurrent cholangitis, among others. 74.3% had IBD (76.7% UC; 21.1%CD, 2.2% indeterminate colitis) and 7.2% (n:9) had colectomy preLT. 30 patients (24.4%) developed rPSC within a mean time of seventy months (10-172mo). Younger age at PSC diagnosis and at LT were the only factors associated with rPSC (p<0.001). Patients with rPSC were at higher risk of developing graft cirrhosis (40% vs 3.2%, p<0.001) and requiring a second graft (30% vs 11.7%, p 0.018).

Conclusions

24.4% developed rPSC in this cohort. Younger age at PSC diagnosis and at transplantation were the only risk factors associated with rPSC.