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21 May 2009

Prediction of graft loss and death in patients with primary sclerosing cholangitis (PSC)

O Kornasiewicz, K Dudek, Z Lewandowski, R Stankiewicz, M Krawczyk

Ann Transplant 2009; 14(1): 44-44 :: ID: 880358


Background: The prognosis of patients with PSC can be accurately determined using Mayo Clinic Score (MRS). This is a mathematical model which predicts patient's survival and helps to determine individual patient's prognosis. The purpose of the study was to determine the risk of graft loss and/or death of patients who were listed or transplanted for PSC.
Material/Methods: We analyzed data of 52 patients, who were placed on the
transplant list due to PSC between January 2000 and November 2008 and either had or hadn't liver transplantation. The primary end point (EP1) of the study was the death of patients of any cause. The secondary composed end point (EP2) was: recurrence of the PSC or appearance of CCC or death related to primary liver disease after OLTx. The time of observation was 60 months. According to obtained MRS the patients were divided into 3 equal groups: group A (MRS<0.56), group B (0.56≤MRS<1.56) and group C (MRS>1.56). Each patient had calculated MRS using Mayo formula. Analysis was performed using the LIFETEST and PHREG Procedure of SAS System.
Results: Risk of EP1 occurence was 2.0 per 1 point of MRS (p<0.0006). Risk of EP2 was 2.1 per 1 point of MRS (p< 0.001). In groups B and C compared with group A the risk of death were: 0.79(NS) and 6.59(p<0.08), respectively. Percentages of 5 years patients survival rate were 94%, 94% and 45% according to groups A, B and C, respectively.
Conclusions: The risk of death in patients with Mayo Risk Score above 1.56 is 6.59 fold higher compared to those with MRS below 0.56 (Group A). MRS greater than 1.56 significantly decreases 5 years survival of patients with primary sclerosing cholangitis.

Keywords: Liver Transplantation, clinical outcome

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358