Recurrence of Primary Sclerosing Cholangitis (Psc) After Hepatic Transplantation: Single Center Experience With 380 Grafts.

Recurrence of autoimmune liver disease after liver transplantation: A systematic review

“…So far, the largest series of patients with PSC recurrence has been reported from the University of Pittsburgh. Abu‐Elmagd et al68 presented their experience with 303 patients who had undergone transplantation for PSC over 16 years. They reported 52 recurrences in the allografts on the basis of typical cholangiographic and histologic features.…”

Risk factors for recurrence of primary sclerosing cholangitis after liver transplantation

“…Our observation of recurrence of PSC in 10% of the patients is within the range of 6%5 to 37%6 reported in the literature. The wide range of reported incidence is attributed to variation in study designs and diagnostic criteria 14. Posttransplantation biliary strictures caused by ischemia (for example, hepatic arterial thrombosis and prolonged cold preservation), infections (for example, CMV infection and cholangitis consequent to Roux loop), immune mediated injury (for example, ABO blood type incompatibility) and chronic ductopenic/arteriopathic rejection make identification of recurrent PSC difficult 19.…”

“…Identification of risk factors for recurrence of PSC is important because it may potentially alter the management of patients posttransplantation,12 and might offer clues to the pathogenesis of PSC 13. A handful of studies have tried to identify the risk factors for recurrence of PSC after LT 6, 8, 9, 12, 14, 15. However, there is little agreement between the different studies on the frequency and risk factors for recurrent PSC.…”

“…However, there is little agreement between the different studies on the frequency and risk factors for recurrent PSC. Recurrence has been associated with older recipient age,14 younger recipient age,8 male gender,6 gender mismatch between donor and recipient,9 presence of inflammatory bowel disease (IBD),14 presence of intact colon after OLT,6 clinically significant cytomegalovirus (CMV) infections,8 recurrent acute cellular rejection (ACR),8 steroid‐resistant ACR,12 and Orthoclone OKT3 (OKT‐3) therapy15 (Table 1). Many previous studies have also been limited by the lack of standardized histological and radiological criteria for definition of recurrent PSC and have not excluded patients with confounding factors.…”

Evolving treatment strategies in thin cutaneous head and neck melanoma: 1 institution's experience

“…Several transplant groups have attempted to identify peritransplantation variables that may predict patients who will develop recurrent PSC. Potential risk factors associated with disease recurrence included recipient age,12, 13 male gender,14 gender mismatch,15 coexistent inflammatory bowel disease (IBD),13 presence of intact colon after liver transplantation,14 cytomegalovirus infection,12 recurrent acute cellular rejection (ACR),12 steroid‐resistant ACR,16 and OKT3 therapy for steroid‐resistant ACR 17. The reasons for these discrepant findings among these studies may be due to the small number of patients with recurrent disease as well as the differences in the study design, the diagnostic criteria, and the interesting and confounding variables considered in the regression model.…”