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Differences in Phenotypes and Liver Transplantation Outcomes by Age Group in Patients with Primary Sclerosing Cholangitis.

Publication ,  Journal Article
Henson, JB; Patel, YA; Wilder, JM; Zheng, J; Chow, S-C; King, LY; Muir, AJ
Published in: Dig Dis Sci
November 2017

BACKGROUND: There is increasing evidence for a heterogeneity of phenotypes in primary sclerosing cholangitis (PSC), but differences across the age spectrum in adults with PSC have not been well characterized. AIMS: To characterize phenotypic variations and liver transplantation outcomes by age group in adults with PSC. METHODS: The United Network for Organ Sharing database was used to identify waitlist registrations for primary liver transplantation in adults with PSC. Patients were split into three age groups: 18-39 (young), 40-59 (middle-aged), and ≥60 (older). Their clinical characteristics and outcomes on the waitlist and post-transplant were compared. RESULTS: Overall, 8272 adults with PSC were listed for liver transplantation during the study period, of which 28.9% were young, 52.0% were middle-aged, and 19.1% were older. The young age group had the greatest male predominance (70.0 vs. 66.2 vs. 65.1%, p = 0.001), the highest proportion of black individuals (20.0 vs. 11.0 vs. 5.5%, p < 0.001), and the most patients listed with concomitant autoimmune hepatitis (2.2 vs. 1.0 vs. 0.8%, p < 0.001). Older patients experienced the greatest waitlist and post-transplant mortality. Graft survival was greatest in the middle-aged group. Young patients were most likely to experience acute rejection (31 vs. 22.8 vs. 18.0%, p < 0.001) and have graft failure due to chronic rejection or PSC recurrence (47.8 vs. 42.3 vs. 17.9%, p < 0.001). CONCLUSIONS: Age-related differences exist among adults with PSC and are associated with outcomes pre- and post-transplant. Young patients may have a more robust immune-related phenotype that is associated with poorer graft survival. Future studies are needed to further investigate these findings.

Duke Scholars

Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

November 2017

Volume

62

Issue

11

Start / End Page

3200 / 3209

Location

United States

Related Subject Headings

  • Young Adult
  • Waiting Lists
  • United States
  • Treatment Outcome
  • Tissue and Organ Procurement
  • Time Factors
  • Sex Distribution
  • Risk Factors
  • Retrospective Studies
  • Recurrence
 

Citation

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Henson, J. B., Patel, Y. A., Wilder, J. M., Zheng, J., Chow, S.-C., King, L. Y., & Muir, A. J. (2017). Differences in Phenotypes and Liver Transplantation Outcomes by Age Group in Patients with Primary Sclerosing Cholangitis. Dig Dis Sci, 62(11), 3200–3209. https://doi.org/10.1007/s10620-017-4559-1
Henson, Jacqueline B., Yuval A. Patel, Julius M. Wilder, Jiayin Zheng, Shein-Chung Chow, Lindsay Y. King, and Andrew J. Muir. “Differences in Phenotypes and Liver Transplantation Outcomes by Age Group in Patients with Primary Sclerosing Cholangitis.Dig Dis Sci 62, no. 11 (November 2017): 3200–3209. https://doi.org/10.1007/s10620-017-4559-1.
Henson JB, Patel YA, Wilder JM, Zheng J, Chow S-C, King LY, et al. Differences in Phenotypes and Liver Transplantation Outcomes by Age Group in Patients with Primary Sclerosing Cholangitis. Dig Dis Sci. 2017 Nov;62(11):3200–9.
Henson, Jacqueline B., et al. “Differences in Phenotypes and Liver Transplantation Outcomes by Age Group in Patients with Primary Sclerosing Cholangitis.Dig Dis Sci, vol. 62, no. 11, Nov. 2017, pp. 3200–09. Pubmed, doi:10.1007/s10620-017-4559-1.
Henson JB, Patel YA, Wilder JM, Zheng J, Chow S-C, King LY, Muir AJ. Differences in Phenotypes and Liver Transplantation Outcomes by Age Group in Patients with Primary Sclerosing Cholangitis. Dig Dis Sci. 2017 Nov;62(11):3200–3209.
Journal cover image

Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

November 2017

Volume

62

Issue

11

Start / End Page

3200 / 3209

Location

United States

Related Subject Headings

  • Young Adult
  • Waiting Lists
  • United States
  • Treatment Outcome
  • Tissue and Organ Procurement
  • Time Factors
  • Sex Distribution
  • Risk Factors
  • Retrospective Studies
  • Recurrence