Carla Fiorella Murillo Perez

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Alkaline phosphatase normalization is associated with a decreased risk for liver transplantation and death in patients with primary biliary cholangitis

Hepatology (2018)

Carla Fiorella Murillo Perez Aliya Gulamhusein Christophe Corpechot Adriaan van der Meer Henk R. van Buuren

Normalization

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Citations (2)

Outcomes of Adult Liver Retransplantation: A Canadian National Database Analysis

Canadian Journal of Gastroenterology and Hepatology (2022)

Peter Yoon Madhukar S. Patel Carla Fiorella Murillo Perez Tommy Ivanics Marco P. A. W. Claasen

Liver retransplantation remains as the only treatment for graft failure. This investigation aims to assess the incidence, post-transplant outcomes, and risk factors in liver retransplantation recipients in Canada.The Canadian Organ Replacement Register was used to obtain and analyse data on all adult liver retransplant recipients, matched donors, transplant-specific variables, and post-transplant outcomes from January 2000 to December 2018.377 (6.5%) patients underwent liver retransplantation. Autoimmune liver disease and hepatitis C virus (HCV) were the most common underlying diagnoses. Graft failure was 7.9% and 12.5%, and overall survival was 77.1% and 65.6% at 1 year and 5 years, respectively. In contrast to recipients receiving their first graft transplant, the retransplantation group had a significantly higher incidence of graft failure (p < 0.001) and lower overall survival (p < 0.001). The graft failure and patient survival rates were comparable between second transplant and repeat retransplant recipients. Furthermore, there were no differences in graft failure and patient survival when stratified according to time to retransplantation. Recipient and donor age (HR = 1.12, p=0.011; HR = 1.09, p=0.008), recipient HCV status (HR = 1.81, p=0.014), and donor cytomegalovirus status (HR = 4.10, p=0.006) were predictors of patient mortality.This analysis of liver retransplantation demonstrates that this is a safe treatment for early and late graft failure. Furthermore, even in patients requiring more than two grafts, similar outcomes to initial retransplantation can be achieved with careful selection.

Liver disease

Hepatitis C

10.1155/2022/9932631

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Citations (11)

Trends in liver transplantation for autoimmune liver diseases: a Canadian study

Canadian Journal of Surgery (2022)

Carla Fiorella Murillo Perez Tommy Ivanics Marco P. A. W. Claasen Peter Yoon David Wallace

To our knowledge, no analysis of data from liver transplantation registries exists in Canada. We aimed to describe temporal trends in the number of liver transplantation procedures, patient characteristics and posttransplantation outcomes for autoimmune liver diseases (AILDs) in Canada.We used administrative data from the Canadian Organ Replacement Register, which contains liver transplantation information from 6 centres in Canada. This study included transplantation information from 5 of the centres, as liver transplantation procedures in children were not included. We included adult (age ≥ 18 yr) patients with a diagnosis of primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH) or overlap syndrome (PBC-AIH or PSC-AIH) who received a liver transplant from 2000 to 2018.Of 5722 primary liver transplantation procedures performed over the study period, 1070 (18.7%) were for an AILD: 489 (45.7%) for PSC, 341 (31.9%) for PBC, 220 (20.6%) for AIH and 20 (1.9%) for overlap syndrome. There was a significant increase in the absolute number of procedures for PSC, with a yearly increase of 0.6 (95% confidence interval 0.1 to 1.2), whereas the absolute number of procedures for PBC and AIH remained stable. The proportion of transplantation procedures decreased for PBC and AIH but remained stable for PSC. Recipient age at transplantation increased over time for males with PBC (median 53 yr in 2000-2005 to 57 yr in 2012-2018, p = 0.03); whereas the median age among patients with AIH decreased, from 53 years in 2000-2005 to 44 years in 2006-2011 (p = 0.03). The Model for Endstage Liver Disease score at the time of transplantation increased over time for all AILDs, particularly AIH (median 16 in 2000-2005 v. 24 in 2012-2018, p < 0.001). There was a trend toward improved survival in the PBC group, with a 5-year survival rate of 81% in 2000-2005 and 90% in 2012-2018 (p = 0.06).Between 2000 and 2018, the absolute number of liver transplantation procedures in Canada increased for PSC but remained stable for PBC and AIH; proportionally, PBC and AIH decreased as indications for transplantation. Posttransplantation survival improved only for the PBC group. An improved understanding of trends and outcomes on a national scale among patients with AILD undergoing liver transplantation can identify disparities and areas for potential health care improvement.

Primary Sclerosing Cholangitis

Autoimmune Hepatitis

Primary Biliary Cirrhosis

Overlap syndrome

10.1503/cjs.012121

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Citations (6)

Role of sarcopenia on outcomes in liver transplantation for hepatocellular carcinoma

HPB (2024)

Luckshi Rajendran Carla Fiorella Murillo Perez A. Brar Marco P. A. W. Claasen Peter Yoon

10.1016/j.hpb.2024.04.277

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Citations (0)

The impact of geographical region on outcomes of patients with primary biliary cholangitis from western Europe

Journal of Hepatology (2020)

Carla Fiorella Murillo Perez Alessio Gerussi Palak Trivedi Christophe Corpechot Adriaan van der Meer

Primary (astronomy)

Primary Sclerosing Cholangitis

10.1016/s0168-8278(20)30701-7

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Citations (0)

FRI-045-Treatment of patients with primary biliary cholangitis with seladelpar for 52 weeks improves predicted transplant-free survival

Journal of Hepatology (2019)

Carla Fiorella Murillo Perez Pol Boudes Alexandra Steinberg Mónika Varga Yun‐Jung Choi

Primary (astronomy)

10.1016/s0618-8278(19)30795-9

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Citations (0)

Serum bile acids are associated with native liver survival in patients with Alagille syndrome: results from the GALA study group

Journal of Hepatology (2023)

Carla Fiorella Murillo Perez Shannon M. Vandriel Jian‐She Wang Liting Li Huiyu She

Alagille Syndrome

10.1016/s0168-8278(23)03024-6

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Citations (0)

Milder disease stage in patients with primary biliary cholangitis over a 44‐year period: A changing natural history

Hepatology (2017)

Carla Fiorella Murillo Perez Jorn Goet Willem J. Lammers Aliya Gulamhusein Henk R. van Buuren

Changes over time in the presenting features and clinical course of patients with primary biliary cholangitis are poorly described. We sought to describe temporal trends in patient and disease characteristics over a 44‐year period across a large international primary biliary cholangitis cohort of 4,805 patients diagnosed between 1970 and 2014, from 17 centers across Europe and North America. Patients were divided into five cohorts according to their year of diagnosis: 1970‐1979 (n = 143), 1980‐1989 (n = 858), 1990‐1999 (n = 1,754), 2000‐2009 (n = 1,815), and ≥2010 (n = 235). Age at diagnosis, disease stage, response to ursodeoxycholic acid, and clinical outcomes were compared. Mean age at diagnosis increased incrementally by 2‐3 years per decade from 46.9 ± 10.1 years in the 1970s to 57.0 ± 12.1 years from 2010 onward ( P < 0.001). The female to male ratio (9:1) and antimitochondrial antibody positivity (90%) were not significantly variable. The proportion of patients presenting with mild biochemical disease (according to Rotterdam staging) increased from 41.3% in the 1970s to 72.2% in the 1990s ( P < 0.001) and remained relatively stable thereafter. Patients with a mild histological stage at diagnosis increased from 60.4% (1970‐1989) to 76.5% (1990‐2014) ( P < 0.001). Correspondingly, response to ursodeoxycholic acid according to Paris‐I criteria increased; 51.7% in the 1970s and 70.5% in the 1990s ( P < 0.001). Recent decades were also characterized by lower decompensation rates (18.5% in the 1970s to 5.8% in the 2000s, P < 0.001) and higher 10‐year transplant‐free survival (48.4%, 68.7%, 79.7%, and 80.1% for each respective cohort; P < 0.001). Conclusion: In recent decades, a pattern of primary biliary cholangitis presentation consistent with an older age at diagnosis alongside reduced disease severity has been noted; the observed trends may be explained by an increase in routine testing of liver function and/or a changing environmental trigger. (H epatology 2018;67:1920‐1930).

Ursodeoxycholic acid

Primary Sclerosing Cholangitis

Decompensation

10.1002/hep.29717

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Citations (70)

Optimising trial design in late-stage primary biliary cholangitis : evaluating options for composite clinical endpoint studies

Hepatology (2019)

Carla Fiorella Murillo Perez Willem J. Lammers Annarosa Floreani Christophe Corpechot Adriaan van der Meer

Clinical endpoint

Primary (astronomy)

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