Graft, patient survival lower after liver transplantation in sarcoidosis

Individuals who had undergone liver transplantation (LT) for sarcoidosis have lower graft and patient survival than those with primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC), a study has found. More than six in 10 patients have survived 5 years following transplantation, which suggests the acceptability of LT in this population.

Using the United Network for Organ Sharing database from 1985 to 2016, the authors examined the clinical characteristics and post-LT outcomes of sarcoidosis patients and compared them to those with PBC and PSC (entire cohort as well as age, gender, and year of LT-matched counterparts).

In the matched design, the authors used a conditional logistic regression for categorical variables and marginal generalized estimating equation for continuous variables. They also constructed survival functions using the Kaplan-Meier estimator.

In total, 206 patients with sarcoidosis who underwent LT during the study period were compared with 3,933 patients with PBC and 5,323 with PSC. In the 1:3 matched analysis, 197 sarcoidosis patients were compared with 576 PBC and 576 PSC patients. The sarcoidosis cohort had a higher number of blacks (53.3 percent) and a higher prevalence of obesity and type 2 diabetes mellitus.

Graft and patient survival were lower for sarcoidosis patients than unmatched PBC and PSC patients, with consistent results in the matched analysis. Patient survival at 5 years was approximately 15-percent lower for sarcoidosis patients than for those with PBC and PSC.

Multivariate analysis using matched data revealed higher hazard ratios (HRs) for graft (HR, 1.68, 95 percent confidence interval [CI], 1.03–2.75; p=0.04) and patient survival (HR, 2.01, 95 percent CI, 1.22–3.34; p<0.01) for sarcoidosis.