Details

Autor(en) / Beteiligte

• Freitas, Louyse Teixeira de Souza
• Hyppolito, Elodie Bomfim
• Barreto, Victor Leonardo
• Júnior, Luiz Humberto Jataí Castelo
• Jorge, Bianca Carneiro de Melo
• Háteras, FCTSB
• Marzola, Malthus Barbosa
• Lima, Clébia Azevedo
• Celedonio, Raquel Mendes
• Coelho, Gustavo Rêgo
• Garcia, Jose Huygens Parente

Titel

Liver transplant in patients with primary sclerosing cholangitis: A retrospective cohort from Northeastern Brazil

Ist Teil von

• World journal of hepatology, 2023-09, Vol.15 (9), p.1033-1042

Ort / Verlag

Baishideng Publishing Group Inc

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Surrogate endpoints are needed to estimate clinical outcomes in primary sclerosing cholangitis (PSC). Serum alkaline phosphatase was among the first markers studied, but there is substantial variability in alkaline phosphatase levels during the natural history of PSC without intervention. The Mayo risk score incorporates noninvasive variables and has served as a surrogate endpoint for survival for more than two decades. Newer models have better test performance than the Mayo risk score, including the primary sclerosing risk estimate tool (PREsTo) model and UK-PSC score that estimate hepatic decompensation and transplant free survival, respectively. The c-statistics for transplant-free survival for the Mayo risk model and the long-term UK-PSC model are 0.68 and 0.85, respectively. The c-statistics for hepatic decompensation for the Mayo risk model and PREsTo model are 0.85 and 0.90, respectively. The Amsterdam-Oxford model included patients with large duct and small duct PSC and patients with PSC-autoimmune hepatitis overlap and had a c-statistic of 0.68 for transplant-free survival. Other noninvasive tests that warrant further validation include magnetic resonance imaging, elastography and the enhanced liver fibrosis score. Prognostic models, noninvasive tests or a combination of these surrogate endpoints may not only serve to be useful in clinical trials of investigational agents, but also serve to inform our patients about their prognosis.