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Trends in liver transplantation for primary biliary cholangitis in Europe over the past three decades
Author(s) -
Harms Maren H.,
Janssen Quisette P.,
Adam Rene,
Duvoux Christophe,
Mirza Darius,
Hidalgo Ernest,
Watson Christopher,
Wigmore Stephen J.,
Pinzani Massimo,
Isoniemi Helena,
Pratschke Johann,
Zieniewicz Krzysztof,
Klempnauer Jurgen L.,
Bennet William,
Karam Vincent,
van Buuren Henk R.,
Hansen Bettina E.,
Metselaar Herold J.
Publication year - 2019
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15060
Subject(s) - medicine , liver transplantation , ursodeoxycholic acid , gastroenterology , primary biliary cirrhosis , transplantation , primary sclerosing cholangitis , liver disease , population , disease , environmental health
Summary Background The importance of primary biliary cholangitis as an indication for liver transplantation has probably been influenced by the introduction of therapies, and changes in selection criteria and disease epidemiology. Aims To assess the time trends in liver transplantation for primary biliary cholangitis and to evaluate the characteristics of the patient population during the past three decades. Methods Patients undergoing liver transplantation from 1986 to 2015 in centres reporting to the European Liver Transplantation Registry were included. We excluded combined organ transplantations and patients <18 years. Trends were assessed using linear regression models. Results We included 112 874 patients, of whom 6029 (5.3%) had primary biliary cholangitis. After an initial increase in the first decade, the annual number of liver transplantation for primary biliary cholangitis remained stable at around 200. The proportion of liver transplantations for primary biliary cholangitis decreased from 20% in 1986 to 4% in 2015 ( P < 0.001). Primary biliary cholangitis was the only indication showing a consistent proportional decrease throughout all decades. From the first to the third decade, the age at liver transplantation increased from 54 (IQR 47‐59) to 56 years (IQR 48‐62) and the proportion of males increased from 11% to 15% (both P < 0.001). Conclusions We have found a proportional decrease in primary biliary cholangitis as indication for liver transplantation. However, despite treatment with ursodeoxycholic acid and improved disease awareness, the absolute annual number of liver transplantations has stabilised.