Prognostic Scores for Ursodeoxycholic Acid-Treated Patients Predict Graft Loss and Mortality in Recurrent Primary Biliary Cholangitis after Liver Transplantation

Aldo J. Montano-Loza; Ellina Lytvyak; Gideon Hirschfield; Bettina E. Hansen; Maryam Ebadi; Thierry Berney; Christian Toso; Giulia Magini; Alejandra Villamil; Frederik Nevens; Natalie Van den Ende; Albert Pares; Pablo Ruiz; Débora Terrabuio; Palak J. Trivedi; Nadir Abbas; Maria Francesca Donato; Lei Yu; Charles Landis; Jérôme Dumortier; Jessica Katharine Dyson; Adriaan J. van der Meer; Rozanne de Veer; Mark Pedersen; Marlyn Mayo; Michael P. Manns; Richard Taubert; Kirchner Theresa; Luca S. Belli; Chiara Mazzarelli; Guido Stirnimann; Annarosa Floreani; Nora Cazzagon; Francesco Paolo Russo; Patrizia Burra; Udi Zigmound; Inbal Houri; Marco Carbone; Giacomo Mulinacci; Stefano Fagiuoli; Daniel Stephan Pratt; Alan Bonder; Thomas D. Schiano; Brandy Haydel; Ansgar Lohse; Christoph Schramm; Darius Rüther; Stefania Casu; Xavier Verhelst; Benedetta Terziroli Beretta-Piccoli; Mercedes Robles; Andrew L. Mason; Christophe Corpechat; Global PBC Study Group

doi:10.1016/j.jhep.2024.05.010

Prognostic Scores for Ursodeoxycholic Acid-Treated Patients Predict Graft Loss and Mortality in Recurrent Primary Biliary Cholangitis after Liver Transplantation

Aldo J. Montano-Loza^*, Ellina Lytvyak, Gideon Hirschfield, Bettina E. Hansen, Maryam Ebadi, Thierry Berney, Christian Toso, Giulia Magini, Alejandra Villamil, Frederik Nevens, Natalie Van den Ende, Albert Pares, Pablo Ruiz, Débora Terrabuio, Palak J. Trivedi, Nadir Abbas, Maria Francesca Donato, Lei Yu, Charles Landis, Jérôme DumortierJessica Katharine Dyson, Adriaan J. van der Meer, Rozanne de Veer, Mark Pedersen, Marlyn Mayo, Michael P. Manns, Richard Taubert, Kirchner Theresa, Luca S. Belli, Chiara Mazzarelli, Guido Stirnimann, Annarosa Floreani, Nora Cazzagon, Francesco Paolo Russo, Patrizia Burra, Udi Zigmound, Inbal Houri, Marco Carbone, Giacomo Mulinacci, Stefano Fagiuoli, Daniel Stephan Pratt, Alan Bonder, Thomas D. Schiano, Brandy Haydel, Ansgar Lohse, Christoph Schramm, Darius Rüther, Stefania Casu, Xavier Verhelst, Benedetta Terziroli Beretta-Piccoli, Mercedes Robles, Andrew L. Mason, Christophe Corpechat, Global PBC Study Group

^*Corresponding author for this work

Immunology and Immunotherapy

Research output: Contribution to journal › Article › peer-review

Abstract

Background/aim Recurrent primary biliary cholangitis (rPBC) develops in approximately 30% of patients and negatively impacts graft and overall patient survival after liver transplantation (LT). There is a lack of data regarding the response rate to ursodeoxycholic acid (UDCA) in rPBC. We evaluated a large, international, multi-center cohort to assess the performance of scores for PBC to predict the risk of graft and overall survival after LT in patients with rPBC. Methods A total of 332 patients with rPBC after LT were evaluated from 28 centres across Europe, North and South America. The median age at the time of rPBC was 58.0 years [IQR 53.2 - 62.6], and 298 patients (90%) were females. The biochemical response was measured with serum levels of alkaline phosphatase (ALP) and bilirubin, and Paris-2, GLOBE and UK-PBC scores at 1 year after UDCA initiation. Results During a median follow-up of 8.7 years [IQR 4.3 - 12.9] after rPBC diagnosis, 52 patients (16%) had graft loss and 103 (31%) died. After 1 year of UDCA initiation the histological stage at rPBC (HR, 3.97, 95%CI 1.36-11.55, P=0.01), use of prednisone (HR 3.18, 95%CI 1.04-9.73, P=0.04), ALP xULN (HR 1.59, 95%CI 1.26-2.01, P

Original language	English
Journal	Journal of Hepatology
Early online date	29 May 2024
DOIs	https://doi.org/10.1016/j.jhep.2024.05.010
Publication status	E-pub ahead of print - 29 May 2024

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Montano-Loza, A. J., Lytvyak, E., Hirschfield, G., Hansen, B. E., Ebadi, M., Berney, T., Toso, C., Magini, G., Villamil, A., Nevens, F., Van den Ende, N., Pares, A., Ruiz, P., Terrabuio, D., Trivedi, P. J., Abbas, N., Donato, M. F., Yu, L., Landis, C., ... Global PBC Study Group (2024). Prognostic Scores for Ursodeoxycholic Acid-Treated Patients Predict Graft Loss and Mortality in Recurrent Primary Biliary Cholangitis after Liver Transplantation. Journal of Hepatology. Advance online publication. https://doi.org/10.1016/j.jhep.2024.05.010

@article{a3bd89e179d74f05826551f92ecd7aa1,

title = "Prognostic Scores for Ursodeoxycholic Acid-Treated Patients Predict Graft Loss and Mortality in Recurrent Primary Biliary Cholangitis after Liver Transplantation",

abstract = "Background/aim Recurrent primary biliary cholangitis (rPBC) develops in approximately 30% of patients and negatively impacts graft and overall patient survival after liver transplantation (LT). There is a lack of data regarding the response rate to ursodeoxycholic acid (UDCA) in rPBC. We evaluated a large, international, multi-center cohort to assess the performance of scores for PBC to predict the risk of graft and overall survival after LT in patients with rPBC. Methods A total of 332 patients with rPBC after LT were evaluated from 28 centres across Europe, North and South America. The median age at the time of rPBC was 58.0 years [IQR 53.2 - 62.6], and 298 patients (90%) were females. The biochemical response was measured with serum levels of alkaline phosphatase (ALP) and bilirubin, and Paris-2, GLOBE and UK-PBC scores at 1 year after UDCA initiation. Results During a median follow-up of 8.7 years [IQR 4.3 - 12.9] after rPBC diagnosis, 52 patients (16%) had graft loss and 103 (31%) died. After 1 year of UDCA initiation the histological stage at rPBC (HR, 3.97, 95%CI 1.36-11.55, P=0.01), use of prednisone (HR 3.18, 95%CI 1.04-9.73, P=0.04), ALP xULN (HR 1.59, 95%CI 1.26-2.01, P",

author = "Montano-Loza, {Aldo J.} and Ellina Lytvyak and Gideon Hirschfield and Hansen, {Bettina E.} and Maryam Ebadi and Thierry Berney and Christian Toso and Giulia Magini and Alejandra Villamil and Frederik Nevens and {Van den Ende}, Natalie and Albert Pares and Pablo Ruiz and D{\'e}bora Terrabuio and Trivedi, {Palak J.} and Nadir Abbas and Donato, {Maria Francesca} and Lei Yu and Charles Landis and J{\'e}r{\^o}me Dumortier and Dyson, {Jessica Katharine} and {van der Meer}, {Adriaan J.} and {de Veer}, Rozanne and Mark Pedersen and Marlyn Mayo and Manns, {Michael P.} and Richard Taubert and Kirchner Theresa and Belli, {Luca S.} and Chiara Mazzarelli and Guido Stirnimann and Annarosa Floreani and Nora Cazzagon and Russo, {Francesco Paolo} and Patrizia Burra and Udi Zigmound and Inbal Houri and Marco Carbone and Giacomo Mulinacci and Stefano Fagiuoli and Pratt, {Daniel Stephan} and Alan Bonder and Schiano, {Thomas D.} and Brandy Haydel and Ansgar Lohse and Christoph Schramm and Darius R{\"u}ther and Stefania Casu and Xavier Verhelst and Beretta-Piccoli, {Benedetta Terziroli} and Mercedes Robles and Mason, {Andrew L.} and Christophe Corpechat and {Global PBC Study Group}",

year = "2024",

month = may,

day = "29",

doi = "10.1016/j.jhep.2024.05.010",

language = "English",

journal = "Journal of Hepatology",

issn = "0168-8278",

publisher = "Elsevier",

}

Montano-Loza, AJ, Lytvyak, E, Hirschfield, G, Hansen, BE, Ebadi, M, Berney, T, Toso, C, Magini, G, Villamil, A, Nevens, F, Van den Ende, N, Pares, A, Ruiz, P, Terrabuio, D, Trivedi, PJ, Abbas, N, Donato, MF, Yu, L, Landis, C, Dumortier, J, Dyson, JK, van der Meer, AJ, de Veer, R, Pedersen, M, Mayo, M, Manns, MP, Taubert, R, Theresa, K, Belli, LS, Mazzarelli, C, Stirnimann, G, Floreani, A, Cazzagon, N, Russo, FP, Burra, P, Zigmound, U, Houri, I, Carbone, M, Mulinacci, G, Fagiuoli, S, Pratt, DS, Bonder, A, Schiano, TD, Haydel, B, Lohse, A, Schramm, C, Rüther, D, Casu, S, Verhelst, X, Beretta-Piccoli, BT, Robles, M, Mason, AL, Corpechat, C & Global PBC Study Group 2024, 'Prognostic Scores for Ursodeoxycholic Acid-Treated Patients Predict Graft Loss and Mortality in Recurrent Primary Biliary Cholangitis after Liver Transplantation', Journal of Hepatology. https://doi.org/10.1016/j.jhep.2024.05.010

TY - JOUR

T1 - Prognostic Scores for Ursodeoxycholic Acid-Treated Patients Predict Graft Loss and Mortality in Recurrent Primary Biliary Cholangitis after Liver Transplantation

AU - Montano-Loza, Aldo J.

AU - Lytvyak, Ellina

AU - Hirschfield, Gideon

AU - Hansen, Bettina E.

AU - Ebadi, Maryam

AU - Berney, Thierry

AU - Toso, Christian

AU - Magini, Giulia

AU - Villamil, Alejandra

AU - Nevens, Frederik

AU - Van den Ende, Natalie

AU - Pares, Albert

AU - Ruiz, Pablo

AU - Terrabuio, Débora

AU - Trivedi, Palak J.

AU - Abbas, Nadir

AU - Donato, Maria Francesca

AU - Yu, Lei

AU - Landis, Charles

AU - Dumortier, Jérôme

AU - Dyson, Jessica Katharine

AU - van der Meer, Adriaan J.

AU - de Veer, Rozanne

AU - Pedersen, Mark

AU - Mayo, Marlyn

AU - Manns, Michael P.

AU - Taubert, Richard

AU - Theresa, Kirchner

AU - Belli, Luca S.

AU - Mazzarelli, Chiara

AU - Stirnimann, Guido

AU - Floreani, Annarosa

AU - Cazzagon, Nora

AU - Russo, Francesco Paolo

AU - Burra, Patrizia

AU - Zigmound, Udi

AU - Houri, Inbal

AU - Carbone, Marco

AU - Mulinacci, Giacomo

AU - Fagiuoli, Stefano

AU - Pratt, Daniel Stephan

AU - Bonder, Alan

AU - Schiano, Thomas D.

AU - Haydel, Brandy

AU - Lohse, Ansgar

AU - Schramm, Christoph

AU - Rüther, Darius

AU - Casu, Stefania

AU - Verhelst, Xavier

AU - Beretta-Piccoli, Benedetta Terziroli

AU - Robles, Mercedes

AU - Mason, Andrew L.

AU - Corpechat, Christophe

AU - Global PBC Study Group

PY - 2024/5/29

Y1 - 2024/5/29

N2 - Background/aim Recurrent primary biliary cholangitis (rPBC) develops in approximately 30% of patients and negatively impacts graft and overall patient survival after liver transplantation (LT). There is a lack of data regarding the response rate to ursodeoxycholic acid (UDCA) in rPBC. We evaluated a large, international, multi-center cohort to assess the performance of scores for PBC to predict the risk of graft and overall survival after LT in patients with rPBC. Methods A total of 332 patients with rPBC after LT were evaluated from 28 centres across Europe, North and South America. The median age at the time of rPBC was 58.0 years [IQR 53.2 - 62.6], and 298 patients (90%) were females. The biochemical response was measured with serum levels of alkaline phosphatase (ALP) and bilirubin, and Paris-2, GLOBE and UK-PBC scores at 1 year after UDCA initiation. Results During a median follow-up of 8.7 years [IQR 4.3 - 12.9] after rPBC diagnosis, 52 patients (16%) had graft loss and 103 (31%) died. After 1 year of UDCA initiation the histological stage at rPBC (HR, 3.97, 95%CI 1.36-11.55, P=0.01), use of prednisone (HR 3.18, 95%CI 1.04-9.73, P=0.04), ALP xULN (HR 1.59, 95%CI 1.26-2.01, P

AB - Background/aim Recurrent primary biliary cholangitis (rPBC) develops in approximately 30% of patients and negatively impacts graft and overall patient survival after liver transplantation (LT). There is a lack of data regarding the response rate to ursodeoxycholic acid (UDCA) in rPBC. We evaluated a large, international, multi-center cohort to assess the performance of scores for PBC to predict the risk of graft and overall survival after LT in patients with rPBC. Methods A total of 332 patients with rPBC after LT were evaluated from 28 centres across Europe, North and South America. The median age at the time of rPBC was 58.0 years [IQR 53.2 - 62.6], and 298 patients (90%) were females. The biochemical response was measured with serum levels of alkaline phosphatase (ALP) and bilirubin, and Paris-2, GLOBE and UK-PBC scores at 1 year after UDCA initiation. Results During a median follow-up of 8.7 years [IQR 4.3 - 12.9] after rPBC diagnosis, 52 patients (16%) had graft loss and 103 (31%) died. After 1 year of UDCA initiation the histological stage at rPBC (HR, 3.97, 95%CI 1.36-11.55, P=0.01), use of prednisone (HR 3.18, 95%CI 1.04-9.73, P=0.04), ALP xULN (HR 1.59, 95%CI 1.26-2.01, P

U2 - 10.1016/j.jhep.2024.05.010

DO - 10.1016/j.jhep.2024.05.010

M3 - Article

SN - 0168-8278

JO - Journal of Hepatology

JF - Journal of Hepatology

ER -

Prognostic Scores for Ursodeoxycholic Acid-Treated Patients Predict Graft Loss and Mortality in Recurrent Primary Biliary Cholangitis after Liver Transplantation

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