Primary sclerosing cholangitis in genetically diverse populations listed for liver transplantation: Unique clinical and human leukocyte antigen associations

Christopher L. Bowlus, Chin Shang Li, Tom H. Karlsen, Benedicte A. Lie, Carlo Selmi

Research output: Contribution to journalArticle

Abstract

Primary sclerosing cholangitis (PSC) is well characterized in European populations. We aimed to characterize clinical characteristics and human leukocyte antigen (HLA) associations in a population of European American, Hispanic, and African American PSC patients listed for liver transplantation (LT). Population-stratified demographic, clinical, and HLA data from 6767 LT registrants of the United Network for Organ Sharing who had a diagnosis of PSC (4.7% of the registrants) were compared to data from registrants with other diagnoses. Compared to European Americans and Hispanics, African Americans were significantly younger (46.6 ± 13.7, 42.3 ± 15.9, and 39.7 ± 13.1 years, respectively; P = 0.002) and were listed with a higher Model for End-Stage Liver Disease score (15.2 ± 7.5, 14.9 ± 7.6, and 18.1 ± 9.3, respectively; P = 0.001); they were also less frequently noted to have inflammatory bowel disease in comparison with European Americans (71.4% versus 60.5%, P <0.01). In multivariate analysis, African origin was a significant factor associated with listing for LT with PSC (odds ratio with respect to European Americans = 1.325, 95% confidence interval = 1.221-1.438). HLA associations in European Americans, Hispanics, and African Americans with PSC versus alcoholic liver disease were detected for HLA-B8, HLA-DR13, and protective HLA-DR4. However, HLA-DR3, which is in linkage disequilibrium with HLA-B8, showed associations only in European Americans and Hispanics. In conclusion, African Americans with PSC who are listed for LT differ clinically from European Americans and Hispanics. The association with HLA-B8 but not HLA-DR3 in African Americans should make possible the refinement of the HLA associations in PSC.

Original languageEnglish
Pages (from-to)1324-1330
Number of pages7
JournalLiver Transplantation
Volume16
Issue number11
DOIs
Publication statusPublished - Nov 2010

Fingerprint

Sclerosing Cholangitis
HLA Antigens
Liver Transplantation
Population
Hispanic Americans
African Americans
Alcoholic Liver Diseases
End Stage Liver Disease
Linkage Disequilibrium
Inflammatory Bowel Diseases
Multivariate Analysis
Odds Ratio
Demography
Confidence Intervals

ASJC Scopus subject areas

  • Surgery
  • Transplantation
  • Hepatology

Cite this

Primary sclerosing cholangitis in genetically diverse populations listed for liver transplantation : Unique clinical and human leukocyte antigen associations. / Bowlus, Christopher L.; Li, Chin Shang; Karlsen, Tom H.; Lie, Benedicte A.; Selmi, Carlo.

In: Liver Transplantation, Vol. 16, No. 11, 11.2010, p. 1324-1330.

Research output: Contribution to journalArticle

@article{70b21cce3c8d494f9e0bdb97b1908c0b,
title = "Primary sclerosing cholangitis in genetically diverse populations listed for liver transplantation: Unique clinical and human leukocyte antigen associations",
abstract = "Primary sclerosing cholangitis (PSC) is well characterized in European populations. We aimed to characterize clinical characteristics and human leukocyte antigen (HLA) associations in a population of European American, Hispanic, and African American PSC patients listed for liver transplantation (LT). Population-stratified demographic, clinical, and HLA data from 6767 LT registrants of the United Network for Organ Sharing who had a diagnosis of PSC (4.7{\%} of the registrants) were compared to data from registrants with other diagnoses. Compared to European Americans and Hispanics, African Americans were significantly younger (46.6 ± 13.7, 42.3 ± 15.9, and 39.7 ± 13.1 years, respectively; P = 0.002) and were listed with a higher Model for End-Stage Liver Disease score (15.2 ± 7.5, 14.9 ± 7.6, and 18.1 ± 9.3, respectively; P = 0.001); they were also less frequently noted to have inflammatory bowel disease in comparison with European Americans (71.4{\%} versus 60.5{\%}, P <0.01). In multivariate analysis, African origin was a significant factor associated with listing for LT with PSC (odds ratio with respect to European Americans = 1.325, 95{\%} confidence interval = 1.221-1.438). HLA associations in European Americans, Hispanics, and African Americans with PSC versus alcoholic liver disease were detected for HLA-B8, HLA-DR13, and protective HLA-DR4. However, HLA-DR3, which is in linkage disequilibrium with HLA-B8, showed associations only in European Americans and Hispanics. In conclusion, African Americans with PSC who are listed for LT differ clinically from European Americans and Hispanics. The association with HLA-B8 but not HLA-DR3 in African Americans should make possible the refinement of the HLA associations in PSC.",
author = "Bowlus, {Christopher L.} and Li, {Chin Shang} and Karlsen, {Tom H.} and Lie, {Benedicte A.} and Carlo Selmi",
year = "2010",
month = "11",
doi = "10.1002/lt.22161",
language = "English",
volume = "16",
pages = "1324--1330",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "11",

}

TY - JOUR

T1 - Primary sclerosing cholangitis in genetically diverse populations listed for liver transplantation

T2 - Unique clinical and human leukocyte antigen associations

AU - Bowlus, Christopher L.

AU - Li, Chin Shang

AU - Karlsen, Tom H.

AU - Lie, Benedicte A.

AU - Selmi, Carlo

PY - 2010/11

Y1 - 2010/11

N2 - Primary sclerosing cholangitis (PSC) is well characterized in European populations. We aimed to characterize clinical characteristics and human leukocyte antigen (HLA) associations in a population of European American, Hispanic, and African American PSC patients listed for liver transplantation (LT). Population-stratified demographic, clinical, and HLA data from 6767 LT registrants of the United Network for Organ Sharing who had a diagnosis of PSC (4.7% of the registrants) were compared to data from registrants with other diagnoses. Compared to European Americans and Hispanics, African Americans were significantly younger (46.6 ± 13.7, 42.3 ± 15.9, and 39.7 ± 13.1 years, respectively; P = 0.002) and were listed with a higher Model for End-Stage Liver Disease score (15.2 ± 7.5, 14.9 ± 7.6, and 18.1 ± 9.3, respectively; P = 0.001); they were also less frequently noted to have inflammatory bowel disease in comparison with European Americans (71.4% versus 60.5%, P <0.01). In multivariate analysis, African origin was a significant factor associated with listing for LT with PSC (odds ratio with respect to European Americans = 1.325, 95% confidence interval = 1.221-1.438). HLA associations in European Americans, Hispanics, and African Americans with PSC versus alcoholic liver disease were detected for HLA-B8, HLA-DR13, and protective HLA-DR4. However, HLA-DR3, which is in linkage disequilibrium with HLA-B8, showed associations only in European Americans and Hispanics. In conclusion, African Americans with PSC who are listed for LT differ clinically from European Americans and Hispanics. The association with HLA-B8 but not HLA-DR3 in African Americans should make possible the refinement of the HLA associations in PSC.

AB - Primary sclerosing cholangitis (PSC) is well characterized in European populations. We aimed to characterize clinical characteristics and human leukocyte antigen (HLA) associations in a population of European American, Hispanic, and African American PSC patients listed for liver transplantation (LT). Population-stratified demographic, clinical, and HLA data from 6767 LT registrants of the United Network for Organ Sharing who had a diagnosis of PSC (4.7% of the registrants) were compared to data from registrants with other diagnoses. Compared to European Americans and Hispanics, African Americans were significantly younger (46.6 ± 13.7, 42.3 ± 15.9, and 39.7 ± 13.1 years, respectively; P = 0.002) and were listed with a higher Model for End-Stage Liver Disease score (15.2 ± 7.5, 14.9 ± 7.6, and 18.1 ± 9.3, respectively; P = 0.001); they were also less frequently noted to have inflammatory bowel disease in comparison with European Americans (71.4% versus 60.5%, P <0.01). In multivariate analysis, African origin was a significant factor associated with listing for LT with PSC (odds ratio with respect to European Americans = 1.325, 95% confidence interval = 1.221-1.438). HLA associations in European Americans, Hispanics, and African Americans with PSC versus alcoholic liver disease were detected for HLA-B8, HLA-DR13, and protective HLA-DR4. However, HLA-DR3, which is in linkage disequilibrium with HLA-B8, showed associations only in European Americans and Hispanics. In conclusion, African Americans with PSC who are listed for LT differ clinically from European Americans and Hispanics. The association with HLA-B8 but not HLA-DR3 in African Americans should make possible the refinement of the HLA associations in PSC.

UR - http://www.scopus.com/inward/record.url?scp=78349269179&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78349269179&partnerID=8YFLogxK

U2 - 10.1002/lt.22161

DO - 10.1002/lt.22161

M3 - Article

C2 - 21031548

AN - SCOPUS:78349269179

VL - 16

SP - 1324

EP - 1330

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 11

ER -