Recent outcomes of liver transplantation for Budd-Chiari syndrome: A study of the European Liver Transplant Registry (ELTR) and affiliated centers

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dc.authoridGómez-Bravo, Miguel A./0000-0002-5155-3508
dc.authoridRotellar, Fernando/0000-0002-6557-0712
dc.authoridDongelmans, Edo/0000-0003-2746-1643
dc.authoridCuervas-Mons, Valentin/0000-0003-3086-9463
dc.authoridPolak, Wojciech/0000-0002-3096-4893
dc.authorwosidGómez-Bravo, Miguel A./KMA-4383-2024
dc.authorwosidRotellar, Fernando/G-7750-2018
dc.authorwosidCuervas-Mons, Valentin/C-8504-2017
dc.contributor.authorDongelmans, Edo
dc.contributor.authorErler, Nicole
dc.contributor.authorAdam, Rene
dc.contributor.authorNadalin, Silvio
dc.contributor.authorKaram, Vincent
dc.contributor.authorYilmaz, Sezai
dc.contributor.authorKelly, Claire
dc.date.accessioned2024-08-04T20:56:07Z
dc.date.available2024-08-04T20:56:07Z
dc.date.issued2024
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground and Aims: Management of Budd-Chiari syndrome (BCS) has improved over the last decades. The main aim was to evaluate the contemporary post-liver transplantant (post-LT) outcomes in Europe. Approach and Results: Data from all patients who underwent transplantation from 1976 to 2020 was obtained from the European Liver Transplant Registry (ELTR). Patients < 16 years with secondary BCS or HCC were excluded. Patient survival (PS) and graft survival (GS) before and after 2000 were compared. Multivariate Cox regression analysis identified predictors of PS and GS after 2000. Supplemental data was requested from all ELTR-affiliated centers and received from 44. In all, 808 patients underwent transplantation between 2000 and 2020. One-, 5- and 10-year PS was 84%, 77%, and 68%, and GS was 79%, 70%, and 62%, respectively. Both significantly improved compared to outcomes before 2000 (p < 0.001). Median follow-up was 50 months and retransplantation rate was 12%. Recipient age (aHR:1.04,95%CI:1.02-1.06) and MELD score (aHR:1.04,95%CI:1.01-1.06), especially above 30, were associated with worse PS, while male sex had better outcomes (aHR:0.63,95%CI:0.41-0.96). Donor age was associated with worse PS (aHR:1.01,95%CI:1.00-1.03) and GS (aHR:1.02,95%CI:1.01-1.03). In 353 patients (44%) with supplemental data, 33% had myeloproliferative neoplasm, 20% underwent TIPS pre-LT, and 85% used anticoagulation post-LT. Post-LT anticoagulation was associated with improved PS (aHR:0.29,95%CI:0.16-0.54) and GS (aHR:0.48,95%CI:0.29-0.81). Hepatic artery thrombosis and portal vein thrombosis (PVT) occurred in 9% and 7%, while recurrent BCS was rare (3%). Conclusions: LT for BCS results in excellent patient- and graft-survival. Older recipient or donor age and higher MELD are associated with poorer outcomes, while long-term anticoagulation improves both patient and graft outcomes.en_US
dc.description.sponsorshipAstellas; Novartis; Institut Georges Lopez; Sandoz; Chiesien_US
dc.description.sponsorshipNo financial support was received for this study. The ELTR is supported by a grant from Astellas, Novartis, Institut Georges Lopez, Sandoz, Chiesi, and logistic support from the Paul Brousse Hospital (Assistance Publique-Hppitaux de Paris).en_US
dc.identifier.doi10.1097/HEP.0000000000000778
dc.identifier.endpage151en_US
dc.identifier.issn0270-9139
dc.identifier.issn1527-3350
dc.identifier.issue1en_US
dc.identifier.pmid38358658en_US
dc.identifier.scopus2-s2.0-85196532463en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage136en_US
dc.identifier.urihttps://doi.org/10.1097/HEP.0000000000000778
dc.identifier.urihttps://hdl.handle.net/11616/102069
dc.identifier.volume80en_US
dc.identifier.wosWOS:001196145300001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofHepatologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectHepatic-Artery Thrombosisen_US
dc.subjectMeld Scoreen_US
dc.subjectSurvivalen_US
dc.subjectExperienceen_US
dc.subjectDiseaseen_US
dc.subjectModelen_US
dc.subjectEpidemiologyen_US
dc.subjectAllocationen_US
dc.subjectPredicten_US
dc.titleRecent outcomes of liver transplantation for Budd-Chiari syndrome: A study of the European Liver Transplant Registry (ELTR) and affiliated centersen_US
dc.typeArticleen_US

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