부산대학교 도서관

BACKGROUND:: The influence of sex on primary sclerosing cholangitis (PSC), pre and post-liver transplantation (LT) is unclear. AIMS:: 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 ELTR database (PSC patients registered before 2018), including baseline demographics, donor, biochemical and clinical data at LT, immunosuppression (IS) and outcome. RESULTS:: ELTR analysis (n=6463, 32% female) demonstrated an increasing number by cohort (1980-89, n=159; 1990-99, n=1282; 2000-09, n=2316; 2010-17, 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 years 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 (CC) at LT, non-DBD 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 year 2000). CONCLUSION:: an increasing number of PSC patients, particularly women, are being transplanted in European countries with better graft outcome in female recipients. Other variables impacting outcome include donor and recipient age, CC, non-DBD donor and reduced graft size.