Outcome following liver transplantation for primary sclerosing cholangitis in the Nordic countries

Abstract

In PSC patients, year of transplantation, previous hepatobiliary surgery and MELD score are predictors of survival following transplantation and these patients are more frequently in need of re-transplantation compared to the comparison group.

Model for End-stage Liver Disease

“…5 Similarly, complications of cirrhosis and portal hypertension such as ascites, variceal bleeding, or hepatic encephalopathy being components of CTP score did not significantly add to accuracy of MELD score suggesting that these complications usually reflect the status of underlying liver function. 26 …”

“…4 The model was later shown to quite accurately predict 3 months mortality amongst patients with chronic end-stage liver disease awaiting LT. 5,6 As the score was objective and could predict mortality at 3 months with higher accuracy than the CTP score, allocation of livers for transplantation became MELD based, deemphasizing the concept of waiting time. 3,7 The score was initially named as Mayo model for endstage liver disease (MELD) score reflecting the institution where the score was developed.…”

“…7,8 Other changes made to the score by the UNOS were: capping serum creatinine at 4 mg/dl, capping the score at 40, and setting the lower limit for each component of the score to 1 in order to avoid negative scores. Further, etiology of the liver disease as a factor was removed from the model, as this did not impact mortality amongst patients with end-stage liver disease awaiting LT. 5 …”

Autoantibodies in primary sclerosing cholangitis

“…No effective medical treatment is currently available [2] and PSC is a major indication for liver transplantation [3] . The PSC population is heterogeneous, comprising subgroups of regular "large-duct" PSC, patients with "small-duct" affection only [4] and an "overlap-syndrome" between PSC and autoimmune hepatitis (AIH) [5] .…”

Different HLA class II associations in ulcerative colitis patients with and without primary sclerosing cholangitis

“…5 No effective medical treatment is currently available 6 and PSC is the major indication for liver transplantation in the Nordic countries. 7 The etiology of PSC remains largely unknown, although complex genetic factors most likely play an important role in the pathogenesis. 8 Approximately 80% of PSC patients of northern European origin have concurrent IBD, the majority UC.…”