Characteristics, Trends, and Outcomes of Liver Transplantation for Primary Sclerosing Cholangitis in Female Versus Male Patients: An Analysis From the European Liver Transplant Registry
Open accessAbstract
Background.: The influence of sex on primary sclerosing cholangitis (PSC), pre- and postliver transplantation (LT) is unclear. Aims are to assess whether there have been changes in incidence, profile, and outcome in LT-PSC patients in Europe with specific emphasis on sex. Methods.: Analysis of the European Liver Transplant Registry database (PSC patients registered before 2018), including baseline demographics, donor, biochemical, and clinical data at LT, immunosuppression, and outcome. Results.: European Liver Transplant Registry analysis (n = 6463, 32% female individuals) demonstrated an increasing number by cohort (1980–1989, n = 159; 1990–1999, n = 1282; 2000–2009, n = 2316; 2010–2017, n = 2549) representing on average 4% of all transplant indications. This increase was more pronounced in women (from 1.8% in the first cohort to 4.3% in the last cohort). Graft survival rate at 1, 5, 10, 15, 20, and 30 y was 83.6%, 70.8%, 57.7%, 44.9%, 30.8%, and 11.6%, respectively. Variables independently associated with worse survival were male sex, donor and recipient age, cholangiocarcinoma at LT, nondonation after brain death donor, and reduced size of the graft. These findings were confirmed using a more recent LT population closer to the current standard of care (LT after the y 2000). Conclusions.: An increasing number of PSC patients, particularly women, are being transplanted in European countries with better graft outcomes in female recipients. Other variables impacting outcome include donor and recipient age, cholangiocarcinoma, nondonation after brain death donor, and reduced graft size.
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PSC represents 4-5% of total liver transplants performed in Europe and North America, with higher rates reported in the Nordic countries.
“Altogether, PSC represents 4-5% of the total liver transplants performed in Europe and North America, 390,391 with higher rates reported in the Nordic countries.392”
From EASL Clinical Practice Guidelines on sclerosing cholangitis (2022) · cites this paper as [391]
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EASL Clinical Practice Guidelines on sclerosing cholangitis
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Self-citation
- Authors
- Berenguer, M., Di Maira, T., Baumann, U., Mirza, D. F., Heneghan, M. A., Klempnauer, J. L., Bennet, W., Ericzon, B.-G., Line, P.-D., Lodge, P. A., Zieniewicz, K., Watson, C. J. E., Metselaar, H. J., Adam, R., Karam, V., & Aguilera, V.
- Affiliations
- Universitat de València (ES)
- Hepatology and Liver Transplant Unit, La Fe University Hospital and Ciberehd, IISLaFe, Valencia, Spain.
- Medizinische Hochschule Hannover (DE)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- National Health Service (GB)
- Sahlgrenska University Hospital (SE)
- Department of Transplantation Surgery, Karolinska University Hospital, Huddinge, Sweden.
- Oslo University Hospital (NO)
- St James's University Hospital (GB)
- Medical University of Warsaw (PL)
- Cambridge University Hospitals NHS Foundation Trust (GB)
- Erasmus MC (NL)
- Université Paris-Sud (FR)
- Hôpital Paul-Brousse (FR)
- Hospital Universitari i Politècnic La Fe (ES)
- Corresponding author
- Berenguer, Marina
- ORCID
- Venue
- Transplantation
- Published
- 2021-10
- Volume
- 105
- Issue
- 10
- Pages
- 2255-2262
- ISSN
- 0041-1337 (ISSN-L)
- OpenAlex
- W3098933494
- Cited by
- 32
- References
- 26
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 9 · 2023: 6 · 2022: 4 · 2021: 3
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- green
- www.scopus.com
- Locations
- Transplantation (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion, cc-by-nc)
- Funders
- Gilead Sciences
- NHS Blood and Transplant
- Astellas Pharma
- Assistance publique-Hôpitaux de Paris
- Instituto de Salud Carlos III (PI19/01360)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Keywords
- primary sclerosing cholangitis, liver transplantation, sex differences, graft survival, cholangiocarcinoma, donor age, donation after brain death, immunosuppression, transplant outcomes, incidence trends
- MeSH terms
- Adult, Europe, Female, Graft Survival, Humans, Male, Middle Aged, Registries, Risk Factors, Sex Factors, Time Factors, Cholangitis, Sclerosing, Incidence, Liver Transplantation, Databases, Factual, Treatment Outcome, Risk Assessment, Health Status Disparities, Healthcare Disparities
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