Risk factors for recurrence of primary sclerosing cholangitis in pediatric liver transplant recipients: A meta-analysis

Table 1 Studies included in this meta-analysis

Ref.	Age at PSC diagnosis (median, range, years)	Gender (male, %)	PSC with LT/total PSC	IBD presence (%)	Follow-up, years	Recurrence n/N (%)	Median time to recurrence, months	Risk factors
Martinez et al[18]	9.5 (7.8-12.3)	61	140/1325	86	3 (1.1-6.1)	36/140 (25.7)	44.4 (19.2-70.8)	1-5
Miloh et al[19]	12.6 ± 3.9 (mean ± SD)	58.2	79/113	51	3.1 ± 2.7	7/79 (8.8)	18.7 ± 13.8	2,3
Feldstein et al[11]	4.7 (1.5-19.6)	65.4	11/52	81	6.6 ± 4.4	3/11 (27.3)	48.4	2,3
Miloh et al[20]	12 (2-20)	62	9/47	59	6.5 (0.5-19)	5/9 (55.6)	84 (48-228)	2,5
Deneau et al[9]	15 (11.9-17.7)	45	113/781	76	4.4 (2-7.9)	51/113 (45.1)	46.1	2-4
Hercun et al[13]	10.85 ± 3.78 (mean ± SD)	59.3	5/27	77.8	8.9 ± 7.3	1/5 (20)	48.6	2-4
Valentino et al[29]	13.4 (10.1, 16.0)	60	6/89	85	3.7 (1.5, 6.9)	1/6 (16.7)	48	2-4
Sathiaseelan et al[24]	11.3	39.2	8/51	73	4.5	4/8 (50)	22	2,4
Umetsu et al[28]	9.0 (6.0-13.5)	56.4	9/39	94.8	5.5 (3.4-8.7)	5/9 (55.56)	84.9 ± 23.3	4

¹Higher rate of Epstein-Barr virus viremia during follow-up.

²Inflammatory bowel disease diagnosed before transplantation.

³Higher alanine aminotransferase, aspartate aminotransferase, and bilirubin levels at the time of liver transplantation.

⁴Primary sclerosing cholangitis-autoimmune hepatitis overlap syndrome.

⁵Higher incidence of acute allograft rejection.

PSC: Primary sclerosing cholangitis; LT: Liver transplantation; IBD: Inflammatory bowel disease.

Table 2 Subgroup analysis results

Ref.	Subgroup characteristics	Hazard ratio (95%CI)	P value
[13,15,21]	Age group: < 10 years	0.58 (0.45-0.75)	< 0.05
[14,16-20]	Age group: ≥ 10 years	0.54 (0.42-0.70)	< 0.05
[13,14,19,20]	Follow-up time: < 5 years	0.56 (0.44-0.72)	< 0.05
[15,16,18,21]	Follow-up time: ≥ 5 years	0.50 (0.38-0.67)	< 0.05
[15,19]	Recurrence rate: Low	0.62 (0.48-0.81)	< 0.05
[13,14,16-18,20,21]	Recurrence rate: High	0.53 (0.41-0.68)	< 0.05