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©The Author(s) 2018.
World J Gastroenterol. Jul 28, 2018; 24(28): 3171-3180
Published online Jul 28, 2018. doi: 10.3748/wjg.v24.i28.3171
Published online Jul 28, 2018. doi: 10.3748/wjg.v24.i28.3171
Table 1 Methodological index for non-randomized studies criteria for selected studies on recurrent primary sclerosing cholangitis after liver transplantation
Study design | Data recording and data quality | Study assessment | MINORS score | ||||||||
Ref. | Year | Study aim | Consecutive patients | Data collection | Reported endpoints | Equivalent groups | Follow-up period | Loss tofollow-up | Outcome evaluation bias | Statistical methods | |
Cholongitas et al[21] | 2008 | 2 | 2 | 1 | 1 | 0 | 2 | 0 | 1 | 2 | 11 |
Alabraba et al[20] | 2009 | 2 | 2 | 1 | 1 | 0 | 2 | 0 | 2 | 2 | 12 |
Moncrief et al[24] | 2010 | 1 | 2 | 1 | 1 | 0 | 2 | 0 | 1 | 2 | 10 |
Gelley et al[22] | 2014 | 1 | 2 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 5 |
Ravikumar et al[25] | 2015 | 2 | 2 | 1 | 2 | 0 | 2 | 0 | 2 | 2 | 13 |
Hildebrand et al[23] | 2016 | 2 | 2 | 1 | 1 | 0 | 2 | 0 | 1 | 2 | 11 |
Table 2 Demographics of study cohorts comparing liver transplantation recipients with and without recurrent primary sclerosing cholangitis in the liver graft
Ref. | Year | Study period | Number n(rPSC vs no rPSC) | Time to diagnosis of rPSC (yr) | Follow-up (yr) | Recipient age at LT (yr) | Recipient gender (male) | MELD at LT | Donor age (yr) | Donor gender (male) | Donor type (DBD) |
Cholongitas et al[21] | 2008 | 1989-2004 | 7 (13) vs 46 (87) | 5 (0.3-10)1 | 9.1 (1-15.4)1 | 35 ± 15 vs 42 ± 132 | 5 (71) vs 25 (54) | NR | 33 ± 18 vs 44 ± 142 | 6 (86) vs 27 (59) | NR |
Alabraba et al[20] | 2009 | 1986-2006 | 61 (23) vs 202 (77) | 4.6 (0.5-12.9)1 | 6.9 (0-19.9)1 | 48 (16-72)1 | 50 (82) vs 149 (74) | NR | NR | NR | 61 (100) vs 202 (100) |
Moncrief et al[24] | 2010 | 1989-2006 | 15 (25) vs 44 (75) | 3.4 (1.5-5.5) | 5.7 (2.8-8.8) | 45 (36-53) vs 47 (37-52) | 13 (87) vs 33 (75) | 18 (13-21) vs 14 (10-21) | NR | NR | NR |
Gelley et al[22] | 2014 | 1995-2011 | 6 (24) vs 19 (76) | NR | NR | 27 ± 7 vs 37 ± 122 | 3 (50) vs 13 (68) | 16 ± 5 vs 11 ± 42 | 39 ± 14 vs 35 ± 112 | NR | NR |
Ravikumar et al[25] | 2015 | 1990-2010 | 81 (14) vs 484 (86) | NR | 9 (5-14) | 43 (34-55) vs 49 (41-57) | 61 (75) vs 344 (71) | NR | 39 (28-53) vs 43 (32-54) | 46 (57) vs 268 (55) | 80 (99) vs 467 (96) |
Hildebrand et al[23] | 2016 | 1990-2006 | 62 (20) vs 243 (80) | 4.6 (0.5-14.3)3 | 8.2 (0-22)3 | 39 ± 11.5 vs 39 ± 10.82 | 48 (77) vs 160 (66) | 16 ± 6 vs 14 ± 72 | 43.6 ± 16 vs 40.1 ± 16.92 | NR | NR |
Table 3 Summary of study outcomes on impact of colectomy on recurrent primary sclerosing cholangitis, inflammatory bowel disease-specific risk factors and non-inflammatory bowel disease-specific risk factors for recurrent primary sclerosing cholangitis
Ref. | Year | Colectomy | IBD-specific risk factor for rPSC | non-IBD risk factor for rPSC |
1Cholongitas et al[21] | 2008 | No effect | Presence of UC post-LT | Need for maintenance steroids post-LT |
Alabraba et al[20] | 2009 | Protective (pre- and peri-LT) | Presence of intact (i.e., retained) colon (independent of IBD or UC) | EDC grafts |
Moncrief et al[24] | 2010 | No effect | None | At least one episode of ACR; CMV mismatch |
Gelley et al[22] | 2014 | No effect | Severe active IBD | Higher donor BMI Younger recipient age |
1Ravikumar et al[25] | 2015 | Protective (univariate analysis) | Presence of UC post-LT | Younger recipient age |
Hildebrand et al[23] | 2016 | No effect | IBD, UC, and in particular active colitis post-LT | Higher donor age; Higher INR at LT |
Table 4 Primary outcomes of study cohorts comparing liver transplantation recipients with and without recurrent primary sclerosing cholangitis in the liver graft
Ref. | Year | Presence of IBD(ever) | Time of IBD diagnosis (pre-LT/de novo) | Presence of IBD (post-LT) | Time of colectomypre- and peri-LT/post-LT | Type of colectomy | Primary immunosuppression | Secondary immunosuppression |
1Cholongitas et al[21] | 2008 | 7 (100) vs 26 (56) | 5 (71)/2 (29) vs 25 (54)/1 (2) | 7 (100) vs 26 (56) | 0 (0)/1 (14) vs 6 (13)/6 (13) | NR | TAC 2 (29) vs 25 (54) CyA 5 (71) vs 21 (46) | AZA 3 (43) vs 22 (48) OKT3 or ATG 2 (29) vs 11 (24) |
Alabraba et al[20] | 2009 | 39 (72) vs 123 (70) | NR | NR | 1 (2)/14 (23) vs 28 (16)/18 (10) | Panproctocolectomy 7 (13) vs 15 (8) Segmental + subtotal 5 (9) vs 21 (12) Ileoanal pouch 3 (6) vs 10 (6) | TAC 16 (26) vs 104 (51) CyA 44 (72) vs 95 (47) | None 1 (2) vs 3 (2) OKT3 0 (0) vs 2 (2) |
Moncrief et al[24] | 2010 | 15 (100) vs 33 (75) | 11 (73)/4 (27) vs 31 (70)/2 (5) | 13 (87) vs 24 (55) | 1 (7)/NR vs 9 (20)/NR | NR | TAC 7 (47) vs 28 (64) CyA 8 (53) vs 14 (32) | NR |
Gelley et al[22] | 2014 | 6 (100) vs 15 (79) | 5 (83)/1 (17) vs 14 (74)/1 (5) | 6 (100) vs 15 (79) | 0 (0)/2 (34) vs 4 (21)/2 (11) | NR | TAC 4 (67) vs 14 (74) CyA 2 (33) vs 5 (26) | NR |
1Ravikumar et al[25] | 2015 | 51 (78) vs 220 (52) | 42 (65)/9 (13) vs 193 (46)/27 (6) | 43 (66) vs 181 (42) | 5 (6)/14 (17) vs 40 (8)/46 (10) | Panproctocolectomy: 2 (2) vs 22 (5) Segmental + subtotal: 16 (20) vs 41 (8) Other: 1 (1) vs 17 (4) | TAC 36 (44) vs 330 (68) CyA 20 (25) vs 55 (11) | AZA 26 (32) vs 212 (44) MMF 10 (12) vs 67 (14) Steroids 38 (47) vs 285 (59) |
Hildebrand et al[23] | 2016 | 53 (86) vs 167 (71) | NR | 48 (77) vs 138 (59) | NR | NR | TAC 41 (67) vs 150 (66) CyA 32 (53) vs 124 (55) | Steroids 41 (70) vs 133 (60) |
- Citation: Buchholz BM, Lykoudis PM, Ravikumar R, Pollok JM, Fusai GK. Role of colectomy in preventing recurrent primary sclerosing cholangitis in liver transplant recipients. World J Gastroenterol 2018; 24(28): 3171-3180
- URL: https://www.wjgnet.com/1007-9327/full/v24/i28/3171.htm
- DOI: https://dx.doi.org/10.3748/wjg.v24.i28.3171