Risk Factors for Primary Sclerosing Cholangitis Recurrence Following Liver Transplantation: A Multicenter Retrospective Analysis

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dc.contributor.authorAdali, Gupse
dc.contributor.authorAcar, Sencan
dc.contributor.authorHarputluoglu, Murat
dc.contributor.authorYilmaz, Tonguc Utku
dc.contributor.authorKarakayali, Hamdi
dc.contributor.authorIstemihan, Zulal
dc.contributor.authorKaymakoglu, Sabahattin
dc.date.accessioned2026-04-04T13:33:22Z
dc.date.available2026-04-04T13:33:22Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractBackground and Aims Primary sclerosing cholangitis recurrence (rPSC) after liver transplantation (LT) is common; however, the factors contributing to rPSC are poorly understood. This study aimed to identify the risk factors for rPSC after LT and determine whether donor type affects rPSC.Methods A multicenter retrospective cohort analysis was conducted on 174 patients with PSC who underwent LT between January 2000 and January 2024. Multivariable Cox models were used to evaluate risk factors for rPSC. The rPSC risk for living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) recipients was compared using Kaplan-Meier survival curves and log-rank tests.Results Of the 174 recipients, 144 (83%) underwent LDLT and 30 (17%) underwent DDLT. Sixty-four (37%) had inflammatory bowel disease (IBD) prior to LT. Thirty-three patients (19%) had rPSC after LT. The median time to rPSC was 28 months (IQR 6-252). Patients with rPSC were younger at the time of PSC diagnosis, and had a higher prevalence of biliary complications after LT and concomitant IBD than those without recurrence. Multivariable Cox regression identified LDLT (HR 3.92, 95% CI 1.06-14.51, p = 0.041), biliary complications (HR 2.18, 95% CI 1.05-4.54, p = 0.037), IBD (HR 2.42, 95% CI 1.20-4.89, p = 0.013), and acute cellular rejection (HR 2.43, 95% CI 1.08-5.48, p = 0.032) as independent risk factors for rPSC.Conclusions This multicenter study identified LDLT, acute cellular rejection, IBD, and biliary complications as independent risk factors for rPSC. These findings underscore the need for individualized post-transplant surveillance and provide important considerations for graft selection and perioperative management in patients with PSC, particularly in settings where LDLT is predominant.
dc.identifier.doi10.1111/ctr.70436
dc.identifier.issn0902-0063
dc.identifier.issn1399-0012
dc.identifier.issue1
dc.identifier.orcid0000-0003-2961-2660
dc.identifier.orcid0000-0003-2157-0304
dc.identifier.orcid0000-0002-3961-8540
dc.identifier.pmid41493043
dc.identifier.scopus2-s2.0-105026813737
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1111/ctr.70436
dc.identifier.urihttps://hdl.handle.net/11616/109108
dc.identifier.volume40
dc.identifier.wosWOS:001654771300001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofClinical Transplantation
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectinflammatory bowel disease
dc.subjectliver transplantation
dc.subjectliving-donor liver transplantation
dc.subjectprimary sclerosing cholangitis
dc.subjectrecurrence
dc.titleRisk Factors for Primary Sclerosing Cholangitis Recurrence Following Liver Transplantation: A Multicenter Retrospective Analysis
dc.typeArticle

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