Trends in liver transplantation for primary biliary cirrhosis in the Netherlands 1988-2008

Kuiper, Edith M. M.; Hansen, Bettina E.; Metselaar, Herold J.; Man, Robert A. de; Haagsma, E. B.; Hoek, Bart van; Buuren, Henk R. van

doi:10.1186/1471-230x-10-144

Cited by 35 publications

(11 citation statements)

References 11 publications

(16 reference statements)

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“…Several useful criteria for the response to UDCA have been developed; however, these criteria cannot fully predict prognosis, and the only subjects with Paris‐II definitions are those with early stage PBC . We diagnose many early stage PBC patients because of progression in clinical examinations, and a predictive marker of progression to cirrhosis in early stage PBC patients is needed. In addition to UDCA, new treatment agents have become available .…”

Section: Discussionmentioning

confidence: 99%

Changes in serum levels of leucine‐rich α2‐glycoprotein predict prognosis in primary biliary cholangitis

Hayashi

Abe

Fujita

et al. 2019

Hepatology Research

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Aims: A non-invasive biomarker for patients with primary biliary cholangitis (PBC) is needed. The association between leucine-rich α2 glycoprotein (LRG) and PBC has not been investigated. We aimed to assess the predictive value of LRG for the development of cirrhosis-related conditions in PBC. Methods:We retrospectively reviewed clinical data of 129 individuals with biopsy-confirmed PBC. Leucine-rich α2 glycoprotein was analyzed by enzyme-linked immunosorbent assays using stored sera at biopsy (n = 129) and after treatment (n = 80).Results: Levels of LRG decreased significantly after treatment (55.8 μg/mL vs. 39.8 μg/mL, P < 0.001). Neither LRG nor delta-LRG was associated with transaminase or histological findings.Delta-LRG >0 (hazard ratio [HR] 4.61, P = 0.013), delta-LRG >0 and an aspartate aminotransferase/platelet ratio index (APRI) >0.76 (HR 458, P < 0.001) were associated with the development of a cirrhosis-related condition. Patients with a delta-LRG >0 and an APRI >0.76 had a significantly increased rate of developing cirrhosis-related conditions (P < 0.001). Conclusions:Changes in LRG levels after treatment predicted PBC prognosis but were not associated with histological stage. Changes in LRG in addition to the APRI could be a useful combination of tools for clinicians as a non-invasive biomarker.

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Section: Discussionmentioning

confidence: 99%

Changes in serum levels of leucine‐rich α2‐glycoprotein predict prognosis in primary biliary cholangitis

Hayashi

Abe

Fujita

et al. 2019

Hepatology Research

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“…Consistent with this change in natural history is the decreasing number of liver transplants performed for PBC in North America and Europe. 7 , 8 …”

Section: Primary Biliary Cirrhosismentioning

confidence: 99%

Current Concepts in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis

Sclair

Little

Levy

2015

Clinical and Translational Gastroenterology

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Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) are chronic, cholestatic diseases of the liver with common clinical manifestations. Early diagnosis and treatment of PBC slows progression and decreases the need for transplant. However, one-third of patients will progress regardless of treatment. Bilirubin <1.0 and alkaline phosphatase <2.0 x the upper limit of normal at 1 year after treatment appear to predict 10-year survival. Ursodeoxycholic acid (UDCA) is the recommended treatment for PBC, and recent studies with obeticholic acid showed promising results for UDCA non-responders. Unlike PBC, no therapy has been shown to alter the natural history of PSC. The recommended initial diagnostic test for PSC is magnetic resonance cholangiopancreatography, typically showing bile duct wall thickening, focal bile duct dilatation, and saccular dilatation of the intra- and/or extrahepatic bile ducts. Immunoglobulin 4-associated cholangitis must be excluded when considering the diagnosis of PSC, to allow for proper treatment, and monitoring of disease progression. In addition to the lack of therapy, PSC is a pre-malignant condition and close surveillance is indicated.

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“…Previous European studies that have assessed trends in liver transplantation for PBC reported a decrease in transplantations. However, these studies were either single centre or single‐country studies, often covered relatively short study periods, or are now outdated . A long‐term European‐wide study is currently lacking, as is data on possible changes over time in the characteristics of the subgroup of patients with PBC who still require liver transplantation.…”

Section: Introductionmentioning

confidence: 99%

Trends in liver transplantation for primary biliary cholangitis in Europe over the past three decades

Harms

Janssen

Adam³

et al. 2018

Aliment Pharmacol Ther

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Summary Background The importance of primary biliary cholangitis as an indication for liver transplantation has probably been influenced by the introduction of therapies, and changes in selection criteria and disease epidemiology. Aims To assess the time trends in liver transplantation for primary biliary cholangitis and to evaluate the characteristics of the patient population during the past three decades. Methods Patients undergoing liver transplantation from 1986 to 2015 in centres reporting to the European Liver Transplantation Registry were included. We excluded combined organ transplantations and patients <18 years. Trends were assessed using linear regression models. Results We included 112 874 patients, of whom 6029 (5.3%) had primary biliary cholangitis. After an initial increase in the first decade, the annual number of liver transplantation for primary biliary cholangitis remained stable at around 200. The proportion of liver transplantations for primary biliary cholangitis decreased from 20% in 1986 to 4% in 2015 ( P < 0.001). Primary biliary cholangitis was the only indication showing a consistent proportional decrease throughout all decades. From the first to the third decade, the age at liver transplantation increased from 54 (IQR 47‐59) to 56 years (IQR 48‐62) and the proportion of males increased from 11% to 15% (both P < 0.001). Conclusions We have found a proportional decrease in primary biliary cholangitis as indication for liver transplantation. However, despite treatment with ursodeoxycholic acid and improved disease awareness, the absolute annual number of liver transplantations has stabilised.

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Trends in liver transplantation for primary biliary cirrhosis in the Netherlands 1988-2008

Cited by 35 publications

References 11 publications

Changes in serum levels of leucine‐rich α2‐glycoprotein predict prognosis in primary biliary cholangitis

Changes in serum levels of leucine‐rich α2‐glycoprotein predict prognosis in primary biliary cholangitis

Current Concepts in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis

Trends in liver transplantation for primary biliary cholangitis in Europe over the past three decades

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