title: Outcome following liver transplantation for primary sclerosing cholangitis in the Nordic countries.
abstract: BACKGROUND
  Primary sclerosing cholangitis (PSC) is the most common indication for liver transplantation in the Nordic countries. Because these patients are difficult to evaluate with regard to timing of liver transplantation, it is important to establish predictors of post-transplant survival.
  
  
  METHODS
  Data from two groups of patients receiving liver allografts during 1982-2001 were recorded: (a) PSC patients and (b) comparison patients. Outcome following transplantation has been recorded for all patients. Regression analyses have been performed for PSC patients to analyse predictors of patient and graft survival.
  
  
  RESULTS
  A total of 245 PSC and 618 comparison patients received a first liver allograft in the period 1982 until the end of the study. The overall 1-, 3- and 5-year patient survival rates were 82%, 77% and 75%, and 80%, 77% and 74% in the PSC group and comparison group, respectively. Survival following transplantation has increased with time in both the PSC and the comparison group. Recent year of transplantation, no previous hepatobiliary surgery and a lower MELD score were predictors of survival following transplantation for PSC patients. PSC patients had a higher rate of re-transplantations (13% versus 8%, P = 0.01). Predictors of re-transplantation in PSC patients were an episode of early rejection and vascular thrombosis.
  
  
  CONCLUSIONS
  In PSC patients, year of transplantation, previous hepatobiliary surgery and MELD score are predictors of survival following transplantation and these patients are more frequently in need of re-transplantation compared to the comparison group.
authors.affiliation: Dept. of Medicine, Rikshospitalet, Oslo, Norway. bjorn.brandsaeter@rikshospitalet.no
authors.forename: B
authors.initials: B
authors.lastname: Brandsaeter
authors.forename: S
authors.initials: S
authors.lastname: Friman
authors.forename: U
authors.initials: U
authors.lastname: Broomé
authors.forename: H
authors.initials: H
authors.lastname: Isoniemi
authors.forename: M
authors.initials: M
authors.lastname: Olausson
authors.forename: L
authors.initials: L
authors.lastname: Bäckman
authors.forename: B
authors.initials: B
authors.lastname: Hansen
authors.forename: E
authors.initials: E
authors.lastname: Schrumpf
authors.forename: A
authors.initials: A
authors.lastname: Oksanen
authors.forename: B G
authors.initials: BG
authors.lastname: Ericzon
authors.forename: K
authors.initials: K
authors.lastname: Höckerstedt
authors.forename: H
authors.initials: H
authors.lastname: Mäkisalo
authors.forename: P
authors.initials: P
authors.lastname: Kirkegaard
authors.forename: K
authors.initials: K
authors.lastname: Bjøro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality; D002648:Child; D015209:Cholangitis, Sclerosing / Q000453:epidemiology / Q000601:surgery*; D002763:Cholecystectomy; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000209:etiology / Q000401:mortality; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000601:surgery; D008105:Liver Cirrhosis, Biliary / Q000601:surgery; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012086:Reoperation; D012189:Retrospective Studies; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome