Background: A decrease in the need for liver transplantations (LTX) in Primary Biliary Cirrhosis (PBC), possibly related to treatment with ursodeoxycholic acid (UDCA), has been reported in the USA and UK. The aim of this study was to assess LTX require

A Pares

Bart van Hoek

Bettina E Hansen

BG Taal

C Corpechot

Edith MM Kuiper

Els B Haagsma

EM Kuiper

ER Dickson

Henk R van Buuren

Herold J Metselaar

J Lee

KN Lazaridis

M Malinchoc

OF James

P Milkiewicz

PS Kamath

RF Liermann Garcia

Robert A de Man

English

PubMed

Kuiper, Edith M. M.

Hansen, Bettina E.

Metselaar, Herold J.

de Man, Robert A.

Haagsma, Els B.

van Hoek, Bart

van Buuren, Henk R.

University of Groningen

Trends in liver transplantation for primary biliary cirrhosis in the Netherlands 1988-2008

Background: A decrease in the need for liver transplantations (LTX) in Primary Biliary Cirrhosis (PBC), possibly related to treatment with ursodeoxycholic acid (UDCA), has been reported in the USA and UK. The aim of this study was to assess LTX requirements in PBC over the past 20 years in the Netherlands. Methods: Analysis of PBC transplant data of the Dutch Organ Transplant Registry during the period 1988-2008, including both absolute and proportional numbers. The indication for LTX was categorized as liver failure, hepatocellular carcinoma or poor quality of life (severe fatigue or pruritus). Data were analysed for two decades: 1.1.1988-31.12.1997 (1(st)) and 1.1.1998-31.12.2007 (2(nd)). The severity of disease was quantified using MELD scores. To fit lines which show trends over time we applied a linear regression model. Results: A total of 110 patients (87% women) was placed on the waiting list. 105 patients were transplanted (1(st): 61, 2(nd): 44), 5 (5%) died while listed. The absolute annual number of LTX for PBC slightly decreased during the 20 year period, the proportional number decreased significantly. At the time of LTX the mean age was 53.6 yrs. (1(st): 53.4, 2(nd): 53.8), the mean MELD score 13.9 (1(st): 14.5, 2(nd): 13.0). The median interval from diagnosis to LTX was 90.5 months (1(st): 86.5, 2(nd): 93.5). 69% of patients was treated with UDCA (1(st) 38%, 2(nd) 82%). Conclusions: Over the past 20 years the absolute number of LTX for PBC in the Netherlands showed a tendency to decrease whereas the proportional decrease was significant. There was a trend over time toward earlier transplantation

Kuiper, E.M.M.

Hansen, B.E.

Metselaar, H.J.

Man, R.A. de

Haagsma, E.B.

Hoek, B. van

Buuren, H.R. van

NARCIS 

Background: A decrease in the need for liver transplantations (LTX) in Primary Biliary Cirrhosis (PBC), possibly related to treatment with ursodeoxycholic acid (UDCA), has been reported in the USA and UK. The aim of this study was to assess LTX requirements in PBC over the past 20 years in the Netherlands.Methods: Analysis of PBC transplant data of the Dutch Organ Transplant Registry during the period 1988-2008, including both absolute and proportional numbers. The indication for LTX was categorized as liver failure, hepatocellular carcinoma or poor quality of life (severe fatigue or pruritus). Data were analysed for two decades: 1.1.1988-31.12.1997 (1(st)) and 1.1.1998-31.12.2007 (2(nd)). The severity of disease was quantified using MELD scores. To fit lines which show trends over time we applied a linear regression model.Results: A total of 110 patients (87% women) was placed on the waiting list. 105 patients were transplanted (1(st): 61, 2(nd): 44), 5 (5%) died while listed. The absolute annual number of LTX for PBC slightly decreased during the 20 year period, the proportional number decreased significantly. At the time of LTX the mean age was 53.6 yrs. (1(st): 53.4, 2(nd): 53.8), the mean MELD score 13.9 (1(st): 14.5, 2(nd): 13.0). The median interval from diagnosis to LTX was 90.5 months (1(st): 86.5, 2(nd): 93.5). 69% of patients was treated with UDCA (1(st) 38%, 2(nd) 82%).Conclusions: Over the past 20 years the absolute number of LTX for PBC in the Netherlands showed a tendency to decrease whereas the proportional decrease was significant. There was a trend over time toward earlier transplantation.</p

Proceedings - University of Groningen

Kuiper, Edith

Hansen, Bettina

Metselaar, Herold

de Man, Rob

Haagsma, EB

van Hoek, B

van Buuren, Henk

EUR Research Repository

Abstract Background A decrease in the need for liver transplantations (LTX) in Primary Biliary Cirrhosis (PBC), possibly related to treatment with ursodeoxycholic acid (UDCA), has been reported in the USA and UK. The aim of this study was to assess LTX requirements in PBC over the past 20 years in the Netherlands. Methods Analysis of PBC transplant data of the Dutch Organ Transplant Registry during the period 1988-2008, including both absolute and proportional numbers. The indication for LTX was categorized as liver failure, hepatocellular carcinoma or poor quality of life (severe fatigue or pruritus). Data were analysed for two decades: 1.1.1988-31.12.1997 (1st) and 1.1.1998-31.12.2007 (2nd). The severity of disease was quantified using MELD scores. To fit lines which show trends over time we applied a linear regression model. Results A total of 110 patients (87% women) was placed on the waiting list. 105 patients were transplanted (1st: 61, 2nd: 44), 5 (5%) died while listed. The absolute annual number of LTX for PBC slightly decreased during the 20 year period, the proportional number decreased significantly. At the time of LTX the mean age was 53.6 yrs. (1st: 53.4, 2nd: 53.8), the mean MELD score 13.9 (1st:14.5, 2nd:13.0). The median interval from diagnosis to LTX was 90.5 months (1st:86.5, 2nd: 93.5). 69% of patients was treated with UDCA (1st 38%, 2nd 82%). Conclusions Over the past 20 years the absolute number of LTX for PBC in the Netherlands showed a tendency to decrease whereas the proportional decrease was significant. There was a trend over time toward earlier transplantation.</p

Haagsma Els B

de Man Robert A

Metselaar Herold J

Hansen Bettina E

Kuiper Edith MM

van Hoek Bart

van Buuren Henk R

Directory of Open Access Journals

BMC Gastroenterology

Abstract
          
            Background
            A decrease in the need for liver transplantations (LTX) in Primary Biliary Cirrhosis (PBC), possibly related to treatment with ursodeoxycholic acid (UDCA), has been reported in the USA and UK. The aim of this study was to assess LTX requirements in PBC over the past 20 years in the Netherlands.
          
          
            Methods
            Analysis of PBC transplant data of the Dutch Organ Transplant Registry during the period 1988-2008, including both absolute and proportional numbers. The indication for LTX was categorized as liver failure, hepatocellular carcinoma or poor quality of life (severe fatigue or pruritus). Data were analysed for two decades: 1.1.1988-31.12.1997 (1st) and 1.1.1998-31.12.2007 (2nd). The severity of disease was quantified using MELD scores. To fit lines which show trends over time we applied a linear regression model.
          
          
            Results
            A total of 110 patients (87% women) was placed on the waiting list. 105 patients were transplanted (1st: 61, 2nd: 44), 5 (5%) died while listed. The absolute annual number of LTX for PBC slightly decreased during the 20 year period, the proportional number decreased significantly. At the time of LTX the mean age was 53.6 yrs. (1st: 53.4, 2nd: 53.8), the mean MELD score 13.9 (1st:14.5, 2nd:13.0). The median interval from diagnosis to LTX was 90.5 months (1st:86.5, 2nd: 93.5). 69% of patients was treated with UDCA (1st 38%, 2nd 82%).
          
          
            Conclusions
            Over the past 20 years the absolute number of LTX for PBC in the Netherlands showed a tendency to decrease whereas the proportional decrease was significant. There was a trend over time toward earlier transplantation.
          </jats:sec

Crossref

et al: Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis. Hepatology

et al: Improved prognosis of patients with primary biliary cirrhosis that have a biochemical response to ursodeoxycholic acid. Gastroenterology

Excellent long-term survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic Acid. Gastroenterology

Feltkamp BE: Clinical diagnosis of primary biliary cirrhosis: a classification based on major and minor criteria. Hepatogastroenterology

Langworthy A: Prognosis in primary biliary cirrhosis: model for decision making. Hepatology

Liver transplantation in primary biliary cirrhosis. Clin Liver Dis

Metcalf JV: Primary biliary cirrhosis once rare, now common in the United Kingdom? Hepatology

N: Transplantation trends in primary biliary cirrhosis. Clin Gastroenterol Hepatol

Talwalkar JA: Clinical epidemiology of primary biliary cirrhosis: incidence, prevalence, and impact of therapy.

ter Borg PC: A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology

Therneau TM, Kosberg CL, et al: A model to predict survival in patients with end-stage liver disease. Hepatology

Transplantation for primary biliary cirrhosis: retrospective analysis of 400 patients in a single center. Hepatology

Trends in liver transplantation for primary biliary cirrhosis in the Netherlands 1988-2008

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University of Groningen

NARCIS

Proceedings - University of Groningen

NARCIS

EUR Research Repository

University of Groningen

Directory of Open Access Journals

Crossref