Outcome of Liver Retransplantation in Patients With Primary Sclerosing Cholangitis

Liver Int. 2025 Jan;45(1):e16214. doi: 10.1111/liv.16214.

Abstract

Background and aims: Primary sclerosing cholangitis (PSC) is among the most common indications for liver transplantation in the Nordic countries and with an increasing trend in Europe and North America. Due to post-transplant complications and high prevalence of disease recurrence this group is at risk of requiring retransplantation (re-LTX). Results from re-LTX for PSC are not extensively studied and there is a lack of knowledge regarding prognosis after re-LTX in this population.

Methods: Graft and patient survival after re-LTX for patients with PSC and a comparable comparison group from the Nordic liver transplant registry were analysed. One-hundred and eighty-five patients with PSC and 208 patients in the comparison group were included.

Results: The graft and patient survival were better for patients with PSC compared to the comparison group (p < 0.001). Re-LTX for recurrence of PSC (rPSC) compared to other aetiologies had similar and better outcomes for graft and patient survival (p = 0.093 and p = 0.023, respectively). Moreover, re-LTX for rPSC compared to the comparison group had a lower 30-day and 5-year mortality (p < 0.001 and p = 0.041, respectively).

Conclusion: Outcomes after retransplantation for PSC were similar or better compared to the comparison group. Retransplantation represents a treatment option with the potential for excellent outcomes in patients with PSC and should be considered in transplanted PSC patients with graft failure.

Keywords: liver transplantation; primary sclerosing cholangitis; retransplantation.

MeSH terms

  • Adult
  • Cholangitis, Sclerosing* / complications
  • Cholangitis, Sclerosing* / mortality
  • Cholangitis, Sclerosing* / surgery
  • Female
  • Graft Survival*
  • Humans
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / mortality
  • Male
  • Middle Aged
  • Recurrence*
  • Registries
  • Reoperation*
  • Retrospective Studies
  • Scandinavian and Nordic Countries / epidemiology
  • Treatment Outcome