The effect of liver transplantation for primary sclerosing cholangitis on disease activity in patients with inflammatory bowel disease.
Bibliographic record
Abstract
Immunosuppressive therapies are indicated following liver transplantation (LT) to prevent graft loss through rejection, and these same agents also may have a role in the management of inflammatory bowel disease (IBD). The aims of this study were to examine the effects of immunosuppression following LT on IBD activity and to identify markers of IBD control post-LT in patients with IBD who underwent LT for primary sclerosing cholangitis (PSC). A retrospective analysis of all adult patients with a pre-LT diagnosis of IBD who underwent LT for PSC over a 15-year period was performed. The primary outcome was IBD activity based on symptomatology and endoscopic assessment. Secondary outcomes included recipient mortality and post-LT development of colorectal cancer or small bowel lymphoma. A total of 105 patients underwent LT for PSC, and IBD was diagnosed in 27 (26%) pre-LT. Patients were followed for a mean of 88.5 months. Fourteen (52%) patients had stable IBD, 6 (22%) had worsening disease, and 7 (26%) had clinical improvement after LT. Colorectal cancer developed in 2 (7%) patients, and small bowel lymphoma developed in 1 (4%) patient. The absence of additional maintenance therapy for IBD was found to be associated with good outcome for IBD control. The use of either infliximab (Remicade, Janssen Biotech) or corticosteroids to control IBD post-LT was associated with poor outcome. Most patients with PSC and IBD had a stable course of IBD post-LT. The need for infliximab or additional or prolonged corticosteroids after LT appears to be a surrogate marker of aggressive disease.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".