A297 Examining the Impact of Inflammatory Bowel Disease in Primary Sclerosing Cholangitis Patients Post Liver Transplantation

Abstract Background Primary sclerosing cholangitis (PSC) is an immune-mediated disease that is characterized by biliary inflammation and fibrosis. It is associated with inflammatory bowel disease (IBD) in 80% of cases. To date, the impact of IBD in liver transplantation (LT) recipients is not completely understood. Aims To assess the impact of IBD in individuals with PSC who underwent liver transplantation (LT) in terms of graft survival, infections, and mortality. Methods This was a retrospective cohort study that included individuals with PSC who received a LT between 1999–2021. Statistical analysis included Kaplan-Meier survival curves, a binary logistic regression to estimate infection risk, and a competing-risk analysis to estimate post-LT mortality (with re-transplantation being a competing risk). Results 122 LT recipients were included. Mean age at LT was 44.9±12.6 years old. The median MELD-Na at LT was 22 17–28. Twenty-nine (23.8%) LT recipients died during follow-up (median 1,248 413–3,857 days) and 5 (4.1%) required re-transplantation (median 1,460 923–2,563 days). Estimated graft survival was 93.2% (95%CI: 86.9%–96.6%) at 1 year and 81.3% (95%CI: 72.5%–87.6%) at 5 years. An adjusted competing-risk model demonstrated that increasing age (sHR 1.05, 95%CI: 1.01–1.10; p=0.018), baseline MELD-Na (sHR 1.07, 95%CI: 1.02–1.12; p=0.005), and ERCP requirements before LT (sHR 6.33; 95%CI: 1.63–24.65; p=0.008) were associated with higher post-LT mortality, while IBD was not associated with post-LT mortality (sHR 1.02, 95%CI: 0.38–2.70; p=0.962). The incidence of infections after LT was 50.8% at 30 days. IBD was not associated with development of infections at 30 days (OR 1.01, 95%CI: 0.98–1.04; p=0.615) post-LT. Conclusions Based on this retrospective review, an older age, higher MELD-Na at LT and prior ERCP requirements were independently associated with a higher mortality post-LT in PSC patients. However, a background history of IBD was not associated with higher mortality or with infections post-LT. Table 1: Baseline Demographics Funding Agencies None