. 2023 Sep 29:36:11729.

doi: 10.3389/ti.2023.11729. eCollection 2023.

Liver Transplantation for Primary Sclerosing Cholangitis (PSC) With or Without Inflammatory Bowel Disease (IBD)-A European Society of Organ Transplantation (ESOT) Consensus Statement

M Carbone^{1

2}, A Della Penna³, C Mazzarelli⁴, E De Martin⁵, C Villard^{2

6}, A Bergquist⁶, P D Line^{7

8

9}, J M Neuberger¹⁰, S Al-Shakhshir¹¹, P J Trivedi¹¹, U Baumann¹², L Cristoferi^{1

2}, J Hov^{7

8

9}, B Fischler^{13

14}, N H Hadzic¹⁵, D Debray¹⁶, L D'Antiga¹⁷, N Selzner¹⁸, L S Belli⁴, S Nadalin³

Affiliations

¹ Centre for Autoimmune Liver Diseases, Department of Medicina and Surgery, University of Milano-Bicocca, Milan, Italy.
² European Reference Network on Hepatological Diseases (ERN RARE-LIVER), IRCCS San Gerardo dei Tintori, Monza, Italy.
³ Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany.
⁴ Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy.
⁵ AP-HP Hôpital Paul-Brousse, Centre Hépato-Biliaire, Inserm Unité 1193, Université Paris-Saclay, FHU Hépatinov, Centre de Référence Maladies Inflammatoires des Voies Biliaires et Hépatites Auto-Immunes, Villejuif, France.
⁶ Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
⁷ Norwegian PSC Research Center and Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
⁸ Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.
⁹ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
¹⁰ Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom.
¹¹ National Institute for Health and Care Research (NIHR) Birmingham Liver Biomedical Research Centre, Centre for Liver and Gastrointestinal Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
¹² Division of Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
¹³ Department of Pediatrics, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
¹⁴ Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
¹⁵ Paediatric Centre for Hepatology, Gastroenterology and Nutrition, King's College, London, United Kingdom.
¹⁶ Unité d'Hépatologie Pédiatrique, Hôpital Necker-Enfants Malades, Centre de Référence Maladies Inflammatoires des Voies Biliaires et Hépatites Auto-Immunes, Filfoie, Paris, France.
¹⁷ Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo, Italy.
¹⁸ Multiorgan Transplant Program, University of Toronto, Toronto, ON, Canada.

PMID: 37841645
PMCID: PMC10570452
DOI: 10.3389/ti.2023.11729

Liver Transplantation for Primary Sclerosing Cholangitis (PSC) With or Without Inflammatory Bowel Disease (IBD)-A European Society of Organ Transplantation (ESOT) Consensus Statement

M Carbone et al. Transpl Int. 2023.

. 2023 Sep 29:36:11729.

doi: 10.3389/ti.2023.11729. eCollection 2023.

Authors

Affiliations

¹ Centre for Autoimmune Liver Diseases, Department of Medicina and Surgery, University of Milano-Bicocca, Milan, Italy.
² European Reference Network on Hepatological Diseases (ERN RARE-LIVER), IRCCS San Gerardo dei Tintori, Monza, Italy.
³ Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany.
⁴ Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy.
⁵ AP-HP Hôpital Paul-Brousse, Centre Hépato-Biliaire, Inserm Unité 1193, Université Paris-Saclay, FHU Hépatinov, Centre de Référence Maladies Inflammatoires des Voies Biliaires et Hépatites Auto-Immunes, Villejuif, France.
⁶ Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
⁷ Norwegian PSC Research Center and Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
⁸ Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.
⁹ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
¹⁰ Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom.
¹¹ National Institute for Health and Care Research (NIHR) Birmingham Liver Biomedical Research Centre, Centre for Liver and Gastrointestinal Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
¹² Division of Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
¹³ Department of Pediatrics, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
¹⁴ Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
¹⁵ Paediatric Centre for Hepatology, Gastroenterology and Nutrition, King's College, London, United Kingdom.
¹⁶ Unité d'Hépatologie Pédiatrique, Hôpital Necker-Enfants Malades, Centre de Référence Maladies Inflammatoires des Voies Biliaires et Hépatites Auto-Immunes, Filfoie, Paris, France.
¹⁷ Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo, Italy.
¹⁸ Multiorgan Transplant Program, University of Toronto, Toronto, ON, Canada.

PMID: 37841645
PMCID: PMC10570452
DOI: 10.3389/ti.2023.11729

Abstract

Primary sclerosing cholangitis (PSC) is the classical hepatobiliary manifestation of inflammatory bowel disease (IBD) and a lead indication for liver transplantation (LT) in the western world. In this article, we present a Consensus Statement on LT practice, developed by a dedicated Guidelines' Taskforce of the European Society of Organ Transplantation (ESOT). The overarching goal is to provide practical guidance on commonly debated topics, including indications and timing of LT, management of bile duct stenosis in patients on the transplant waiting list, technical aspects of transplantation, immunosuppressive strategies post-transplant, timing and extension of intestinal resection and futility criteria for re-transplantation.

Keywords: IBD; PSC; immunosuppression; liver transplantation; retransplantation.

Copyright © 2023 Carbone, Della Penna, Mazzarelli, De Martin, Villard, Bergquist, Line, Neuberger, Al-Shakhshir, Trivedi, Baumann, Cristoferi, Hov, Fischler, Hadzic, Debray, D’Antiga, Selzner, Belli and Nadalin.

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Conflict of interest statement

MC has received grant support unrelated to this study from Genetics spa, PSC Pediatric Foundation, AMAF, EpaC and AIRCS. He also received speakers/consultancy/advisory fees for GlaxoSmithKline, Dr. Falk Pharma, Cymabay, Advanz Pharma, Albireo, Ipsen, Mayoly Spindler, Perspectum, Echosens, Kowa, and Mirun. PT receives institutional support from Birmingham NIHR BRC. Unrelated to this study PT has received grant support from the Wellcome Trust, Innovate UK, the Medical Research Foundation, GlaxoSmithKline (GSK), Guts UK, PSC Support, LifeArc, NIHR, Intercept Pharma, Dr. Falk Pharma, Gilead Sciences, and Bristol Myers Squibb. He has also received speaker fees from Intercept and Dr. Falk, and advisory board/consultancy fees from Intercept, Cymabay, Pliant Pharma, Dr. Falk, Albireo, Ipsen and GlaxoSmithKine. HNH consultancies for Arrowhead, Takeda, GLG, Albireo, Alnylam and Mirum. LC received speakers fee from Advanz and Echosens. LD’A received consultancy fees from: Albireo, Mirum, Alexion, Astra Zeneca, Selecta, Vivet, Spark, Genespire, and Tome, in fields unrelated to the current topic. DD received consultancy fees from: Mirum, Vertex, Orphalan, Univar, Alexion, in fields unrelated to this study. UB received consultancy fees or grant support from: Mirum, Albireo, Alexion, Nestle and Vivet in fields unrelated to this study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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References

1. European Association for the Study of the Liver. Electronic Address: easloffice@easloffice.eu; European Association for the Study of the LiverEuropean Association for the Study of the Liver. EASL Clinical Practice Guidelines on Sclerosing Cholangitis. J Hepatol (2022) 77(3):761–806. 10.1016/j.jhep.2022.05.011 - DOI - PubMed
1. Andersen IM, Fosby B, Boberg KM, Clausen OP, Jebsen P, Melum E, et al. Indications and Outcomes in Liver Transplantation in Patients With Primary Sclerosing Cholangitis in Norway. Transpl Direct (2015) 1(9):e39. 10.1097/TXD.0000000000000548 - DOI - PMC - PubMed
1. Liaskou E, Quraishi MN, Trivedi PJ. Mucosal Immunity in Primary Sclerosing Cholangitis: From the Bowel to Bile Ducts and Back Again. Curr Opin Gastroenterol (2022) 38(2):104–13. 10.1097/MOG.0000000000000809 - DOI - PubMed
1. Hov JR, Karlsen TH. The Microbiota and the Gut-Liver Axis in Primary Sclerosing Cholangitis. Nat Rev Gastroenterol Hepatol (2023) 20(3):135–54. 10.1038/s41575-022-00690-y - DOI - PubMed
1. Cillo U, Weissenbacher A, Pengel L, Jochmans I, Roppolo D, Amarelli C, et al. ESOT Consensus Platform for Organ Transplantation: Setting the Stage for a Rigorous, Regularly Updated Development Process. Transpl Int (2022) 35:10915. 10.3389/ti.2022.10915 - DOI - PMC - PubMed

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Liver Transplantation for Primary Sclerosing Cholangitis (PSC) With or Without Inflammatory Bowel Disease (IBD)-A European Society of Organ Transplantation (ESOT) Consensus Statement

Affiliations

Liver Transplantation for Primary Sclerosing Cholangitis (PSC) With or Without Inflammatory Bowel Disease (IBD)-A European Society of Organ Transplantation (ESOT) Consensus Statement

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Conflict of interest statement

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