Observational studyHepatology (Baltimore, Md.)2021
Recurrence of Primary Sclerosing Cholangitis After Liver Transplant in Children: An International Observational Study.
Observational study in Hepatology (Baltimore, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Autoimmune hepatitis in children: Guidelines of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).Hepatology international · 2025Guideline
- Primary sclerosing cholangitis in children with inflammatory bowel disease: An ESPGHAN position paper from the Hepatology Committee and the IBD Porto group.Journal of pediatric gastroenterology and nutrition · 2025Guideline
- Risk factors for recurrence of primary sclerosing cholangitis in pediatric liver transplant recipients: A meta-analysis.World journal of gastrointestinal surgery · 2025Article
- Natural history and prognosis of pediatric PSC with updates on management.Clinical liver disease · 2023Article
- Analysis of Pathogenic Bacteria Distribution and Related Factors in Recurrent Acute Cholangitis.Infection and drug resistance · 2023Article
- Immune microenvironment changes of liver cirrhosis: emerging role of mesenchymal stromal cells.Frontiers in immunology · 2023Review
- Posttransplant considerations in autoimmune liver disease: Recurrence of disease andClinical liver disease · 2022Review
- Antibody-Mediated Rejection and Recurrent Primary Disease: Two Main Obstacles in Abdominal Kidney, Liver, and Pancreas Transplants.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
36 authors at 20 institutions in 11 countries.
Funding
Abstract
BACKGROUND AND
aimsRecurrent primary sclerosing cholangitis (rPSC) following liver transplant (LT) has a negative impact on graft and patient survival; little is known about risk factors for rPSC or disease course in children. APPROACH AND
resultsWe retrospectively evaluated risk factors for rPSC in 140 children from the Pediatric PSC Consortium, a multicenter international registry. Recipients underwent LT for PSC and had >90 days of follow-up. The primary outcome, rPSC, was defined using Graziadei criteria. Median follow-up after LT was 3 years (interquartile range 1.1-6.1). rPSC occurred in 36 children, representing 10% and 27% of the subjects at 2 years and 5 years following LT, respectively. Subjects with rPSC were younger at LT (12.9 vs. 16.2 years), had faster progression from PSC diagnosis to LT (2.5 vs. 4.1 years), and had higher alanine aminotransferase (112 vs. 66 IU/L) at LT (all P < 0.01). Inflammatory bowel disease was more prevalent in the rPSC group (86% vs. 66%; P = 0.025). After LT, rPSC subjects had more episodes of biopsy-proved acute rejection (mean 3 vs. 1; P < 0.001), and higher prevalence of steroid-refractory rejection (41% vs. 20%; P = 0.04). In those with rPSC, 43% developed complications of portal hypertension, were relisted for LT, or died within 2 years of the diagnosis. Mortality was higher in the rPSC group (11.1% vs. 2.9%; P = 0.05).
conclusionsThe incidence of rPSC in this cohort was higher than previously reported, and was associated with increased morbidity and mortality. Patients with rPSC appeared to have a more aggressive, immune-reactive phenotype. These findings underscore the need to understand the immune mechanisms of rPSC, to lay the foundation for developing new therapies and improve outcomes in this challenging population.
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