Evidence map›Paper›PMID 39888688›Full record

ArticleThe American journal of gastroenterology2025

Severe Cholestasis Predicts Recurrent Primary Sclerosing Cholangitis Following Liver Transplantation.

Bishoi Aziz, Beverley Kok, Matthew Cheah, Ellina Lytvyak, Carlos Moctezuma-Velazquez, Shawn Wasilenko, Emmanuel Tsochatzis, Reena Ravikumar, Sophie Jose, Michael Allison and 19 more

Abstract read
In one paragraph

Article in The American journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Bishoi AzizDivision of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.
Beverley KokSheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.ORCID 0000-0002-8762-753
Matthew CheahDivision of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.ORCID 0000-0001-7312-9495
Ellina LytvyakDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0001-5651-9010
Carlos Moctezuma-VelazquezDivision of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.ORCID 0000-0003-2367-2742
Shawn WasilenkoDivision of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.
Emmanuel TsochatzisSheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.ORCID 0000-0001-5069-2461
Reena RavikumarSheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.
Sophie JoseResearch Department of Infection and Population Health, University College London, UK.
Michael AllisonCambridge Transplant Unit, Cambridge University Hospitals, Cambridge, UK.ORCID 0000-0003-3677-3294
Bridget GunsonThe Liver Unit, University Hospital Birmingham, Birmingham, UK.
Derek ManasInstitute of Transplantation, Freeman Hospital, Newcastle, UK.ORCID 0000-0003-3066-4601
Andrea MonacoSheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.
Darius MirzaThe Liver Unit, University Hospital Birmingham, Birmingham, UK.
Giuseppe FusaiSheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.
Nicola OwenCambridge Transplant Unit, Cambridge University Hospitals, Cambridge, UK.
Douglas ThorburnSheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.ORCID 0000-0002-5610-5448
Keith RobertsThe Liver Unit, University Hospital Birmingham, Birmingham, UK.
Parthi SrinivasanInstitute of Liver Studies, Kings College Hospital, London, UK.ORCID 0000-0002-3004-1335
Stephen WigmoreDepartment of HPB and Liver Transplant Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland.ORCID 0000-0002-3614-8002
Anuja AthaleInstitute of Liver Studies, Kings College Hospital, London, UK.
Felicity CreamerDepartment of HPB and Liver Transplant Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland.
Bimbi FernandoSheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.ORCID 0009-0003-1859-8872
Vikram IyerRoyal Melbourne Hospital, Parkville, Australia.ORCID 0000-0002-3697-2106
Mansoor MadanurInstitute of Liver Studies, Kings College Hospital, London, UK.
Gourab SenInstitute of Transplantation, Freeman Hospital, Newcastle, UK.ORCID 0000-0002-3081-3729
Aldo J Montano-LozaDivision of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.ORCID 0000-0002-2511-7980
Bettina HansenToronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada .
Andrew L MasonDivision of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.ORCID 0000-0002-0470-9522

Funding

Canadian Institutes of Health Research, Canadian National Transplant Research Program, Canadian Liver Foundation
6 · The paper itself

Abstract

introductionPrimary sclerosing cholangitis (PSC) may reoccur following liver transplantation (LT), and the diagnosis established once imaging studies demonstrate the diagnostic cholangiographic appearance. To evaluate whether the development of recurrent PSC (rPSC) is associated with cholestasis soon after LT, we studied whether changes in hepatic biochemistry within the first 12 months were linked with the development of rPSC and graft loss.

methodsWe conducted a retrospective cohort analysis of 158 transplant recipients with PSC in Canada and 549 PSC transplant recipients from the United Kingdom. We evaluated serum liver tests within 12 months after LT and the subsequent development of a cholangiographic diagnosis of rPSC as a time-dependent covariate using Cox regression. Severe cholestasis was defined as either alkaline phosphatase > 3× upper limit of normal or total bilirubin > 100 μmol/L.

resultsPatients who developed rPSC were more likely to have severe cholestasis vs those without at 3 months (20.5% vs 8.2%, P = 0.011), at 6 months (17.9% vs 10.0%, P = 0.026), and 12 months (15.4% vs 7.8%, P = 0.051) in the Canadian cohort and at 12 months in the UK cohort (27.9% vs 12.6%, P < 0.0001). By multivariable analysis, development of severe cholestasis in the Canadian cohort at 3 months (hazard ratio [HR] = 2.41, P = 0.046) and in the UK cohort at 12 months (HR = 3.141, P < 0.0001) was both associated with rPSC. Severe cholestasis at 3 months in the Canadian cohort was predictive of graft loss (HR = 3.88, P = 0.0001). DISCUSSION: The development of cholestasis within 3-12 months following LT was predictive of rPSC and graft loss.

Indexed as

Cholangitis, SclerosingCholestasisLiver TransplantationAdultAlkaline PhosphataseBilirubinCanadaFemaleHumansLiver Function TestsMaleMiddle AgedProportional Hazards ModelsRecurrenceRetrospective StudiesSeverity of Illness IndexAlkaline PhosphataseBilirubin

Identifiers

PMID39888688
PMCPMC11774198

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.