Molinaro Antonio, Engesæter Lise Katrine, Jorns Carl, Nordin Arno, Rasmussen Allan, Line Pål-Dag, Pall Virge, Ericzon Bo-Göran, Bennet William, Hov Johannes R, Melum Espen
Department of Molecular and Clinical Medicine, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden.
Norwegian PSC Research Center, Division of Surgery and Specialized Medicine, Oslo University Hospital, Oslo, Norway.
Liver Int. 2025 Jan;45(1):e16214. doi: 10.1111/liv.16214.
Primary sclerosing cholangitis (PSC) is among the most common indications for liver transplantation in the Nordic countries and with an increasing trend in Europe and North America. Due to post-transplant complications and high prevalence of disease recurrence this group is at risk of requiring retransplantation (re-LTX). Results from re-LTX for PSC are not extensively studied and there is a lack of knowledge regarding prognosis after re-LTX in this population.
Graft and patient survival after re-LTX for patients with PSC and a comparable comparison group from the Nordic liver transplant registry were analysed. One-hundred and eighty-five patients with PSC and 208 patients in the comparison group were included.
The graft and patient survival were better for patients with PSC compared to the comparison group (p < 0.001). Re-LTX for recurrence of PSC (rPSC) compared to other aetiologies had similar and better outcomes for graft and patient survival (p = 0.093 and p = 0.023, respectively). Moreover, re-LTX for rPSC compared to the comparison group had a lower 30-day and 5-year mortality (p < 0.001 and p = 0.041, respectively).
Outcomes after retransplantation for PSC were similar or better compared to the comparison group. Retransplantation represents a treatment option with the potential for excellent outcomes in patients with PSC and should be considered in transplanted PSC patients with graft failure.
原发性硬化性胆管炎（PSC）是北欧国家肝移植最常见的适应证之一，在欧洲和北美呈上升趋势。由于移植后并发症和疾病复发率高，该群体有再次移植（re-LTX）的风险。关于PSC再次移植的结果尚未得到广泛研究，且对于该人群再次移植后的预后缺乏了解。
分析了北欧肝移植登记处中PSC患者再次移植后的移植物和患者生存率，并与一个可比的对照组进行比较。纳入了185例PSC患者和208例对照组患者。
与对照组相比，PSC患者的移植物和患者生存率更高（p < 0.001）。与其他病因相比，PSC复发（rPSC）的再次移植在移植物和患者生存率方面有相似且更好的结果（分别为p = 0.093和p = 0.023）。此外，与对照组相比，rPSC的再次移植30天和5年死亡率更低（分别为p < 0.001和p = 0.041）。
与对照组相比，PSC再次移植后的结果相似或更好。再次移植是PSC患者可能获得良好结果的一种治疗选择，对于移植后移植物失败的PSC患者应予以考虑。
