TY - JOUR
T1 - Intestinal Bacteremia After Liver Transplantation Is a Risk Factor for Recurrence of Primary Sclerosing Cholangitis
AU - Mammadov, Ruslan A.
AU - Selten, Jasmijn W.
AU - Roest, Henk P.
AU - Verhoeven, Cornelia J.
AU - Maroni, Luca
AU - Bril, Sandra I.
AU - Tolenaars, Dagmar
AU - Gadjradj, Pravesh S.
AU - van de Graaf, Stan F. J.
AU - Oude Elferink, Ronald P. J.
AU - Kwekkeboom, Jaap
AU - Metselaar, Herold J.
AU - Peppelenbosch, Maikel P.
AU - Beuers, Ulrich
AU - Ijzermans, Jan N. M.
AU - van der Laan, Luc J. W.
N1 - Publisher Copyright: Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Background. Primary sclerosing cholangitis (PSC) is a chronic progressive pathological process, related to inflammatory bowel disease and subsequent bacterial translocation. Liver transplantation (LT) is the only curative therapy, but outcomes are compromised by recurrence of PSC (rPSC). The aim of the study was to investigate a potential link between intestinal bacteremia, fucosyltransferase-2 (FUT2), and rPSC after LT. Methods. LT recipients with PSC (n = 81) or without PSC (n = 271) were analyzed for clinical outcomes and positive bacterial blood cultures. A link between bacteremia and the genetic variant of the FUT2 gene was investigated. Results. The incidence of inflammatory bowel disease was significantly higher in PSC recipients but not associated with rPSC. Bacteremia occurred in 31% of PSC recipients. The incidence of rPSC was 37% and was significantly more common in patients with intestinal bacteremia versus no bacteremia (82% versus 30%; P = 0.003). The nonsecretor polymorphism of the FUT2 gene was identified as a genetic risk factor for both intestinal bacteremia and rPSC. Combined FUT2 genotype and intestinal bacteremia in recipients resulted in the highest risk for rPSC (hazard ratio, 15.3; P < 0.001). Conclusions. Thus, in this article, we showed that bacterial translocation is associated with rPSC after LT and related to the FUT2 nonsecretor status.
AB - Background. Primary sclerosing cholangitis (PSC) is a chronic progressive pathological process, related to inflammatory bowel disease and subsequent bacterial translocation. Liver transplantation (LT) is the only curative therapy, but outcomes are compromised by recurrence of PSC (rPSC). The aim of the study was to investigate a potential link between intestinal bacteremia, fucosyltransferase-2 (FUT2), and rPSC after LT. Methods. LT recipients with PSC (n = 81) or without PSC (n = 271) were analyzed for clinical outcomes and positive bacterial blood cultures. A link between bacteremia and the genetic variant of the FUT2 gene was investigated. Results. The incidence of inflammatory bowel disease was significantly higher in PSC recipients but not associated with rPSC. Bacteremia occurred in 31% of PSC recipients. The incidence of rPSC was 37% and was significantly more common in patients with intestinal bacteremia versus no bacteremia (82% versus 30%; P = 0.003). The nonsecretor polymorphism of the FUT2 gene was identified as a genetic risk factor for both intestinal bacteremia and rPSC. Combined FUT2 genotype and intestinal bacteremia in recipients resulted in the highest risk for rPSC (hazard ratio, 15.3; P < 0.001). Conclusions. Thus, in this article, we showed that bacterial translocation is associated with rPSC after LT and related to the FUT2 nonsecretor status.
UR - http://www.scopus.com/inward/record.url?scp=85164830706&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/TP.0000000000004563
DO - https://doi.org/10.1097/TP.0000000000004563
M3 - Article
C2 - 36978227
SN - 0041-1337
VL - 107
SP - 1764
EP - 1775
JO - Transplantation
JF - Transplantation
IS - 8
ER -