A259 ELEVATED BIOCHEMICAL LIVER TESTS WITHIN 1-YEAR TRANSPLANT PREDICTS RECURRENT PSC
Bibliographic record
Abstract
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease affecting bile ducts leading to cirrhosis and end-stage liver disease. Liver transplant is the only effective treatment however 6–59% of those transplanted develop recurrent PSC (rPSC). Many risk factors for recurrence have been proposed yet only the presence of ulcerative colitis has been validated in multiple studies. We hypothesized patients who develop rPSC have elevated liver tests within the first year following transplant, as previously observed with recurrent hepatitis C and recurrent autoimmune hepatitis. To determine if elevated liver tests within 1 year of transplant predicts rPSC. PSC patients who underwent liver transplant at the University of Alberta Hospital from 1991 to 2015 were included. Recurrent PSC was defined by cholangiography and/or histological findings. Recurrence free survival and graft loss was compared between patients with and without rPSC. Liver tests including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and bilirubin were assessed at 3, 6, 9, and 12 months after liver transplant. Abnormal liver tests were defined as values above the ULN for ALT, AST and bilirubin or 1.5XULN for ALP. One hundred and thirty-one patients were included. Mean transplant age was 43 years with 98 (75%) males and rPSC occurred in 40/131 (30%) patients. Mean recurrence time was 70 months (4 to 172 months) with rPSC rates of 4% and 20%, at 1 and 5 years, respectively. Median survival time was similar between rPSC and non-rPSC (132 ± 11 vs 175 ± 13 months, P=0.28). Mean time to graft loss was lower in those with rPSC (109 ± 12 vs 180 ± 13 months, P=0.003). Recurrent PSC patients with AST and ALT≥ULN at 12 months had disease recurrence occur earlier than those with normal AST and ALT (19 ± 17 vs 78 ± 50 months, P=0.001) and rPSC developed sooner in patients with ALP≥1.5XULN and ALT≥ULN at 6, 9, and 12 months inclusive (13 ± 4 vs 66 ± 51months, P=0.001). Multiple liver test abnormalities were identified that predict the development of rPSC (see table). Post-transplant abnormal hepatocellular and cholestatic biochemical liver tests within the 1st year or transplant predicts rPSC. Hazard Ratios (HR) for Developing rPSC: None
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".