Systematic review with meta-analysis: risk factors for recurrent primary sclerosing cholangitis after liver transplantation.
Aliment Pharmacol Ther
; 49(6): 636-643, 2019 03.
Article
en En
| MEDLINE
| ID: mdl-30740723
ABSTRACT
BACKGROUND:
After liver transplantation primary sclerosing cholangitis (PSC), the condition returns in the transplanted liver in a subset of patients (recurrent primary sclerosing cholangitis, rPSC).AIM:
To define risk factors for rPSC.METHODS:
We searched Pubmed, Embase, Web of Science, and Cochrane library for articles published until March 2018. Studies addressing risk factors for developing rPSC were eligible for inclusion. A random effects meta-analysis was conducted using hazard ratios (HR) as effect measure. Study quality was evaluated with the Newcastle Ottawa scale. Statistical analysis was performed using Cochrane Review Manager.RESULTS:
The electronic database search yielded 449 results. Twenty-one retrospective cohort studies met the inclusion criteria for the review; 14 were included in the meta-analysis. The final cohort included 2159 patients (age range 31-49 years, 68.8% male), of whom 17.7% developed rPSC. Colectomy before liver transplantation, HR 0.65 (95% CI 0.42-0.99), cholangiocarcinoma before liver transplantation, HR 2.42 (95% CI 1.20-4.86), inflammatory bowel disease, HR 1.73 (95% CI 1.17-2.54), donor age, HR 1.24 (95% CI 1.0-1.45) per ten years, MELD score, HR 1.05 (95% CI 1.02-1.08) per point and acute cellular rejection, HR of 1.94 (95% CI 1.32-2.83) were associated with the risk of rPSC.CONCLUSIONS:
Multiple risk factors for rPSC were identified. Colectomy before liver transplantation reduced the risk of rPSC.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Colangitis Esclerosante
/
Trasplante de Hígado
/
Colectomía
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Aliment Pharmacol Ther
Asunto de la revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2019
Tipo del documento:
Article
País de afiliación:
Países Bajos