Safety of Endoscopic Retrograde Cholangiopancreatography (ERCP) in Liver Transplant Patients: A Population-Based Propensity-Matched Study

Document Type

Conference Proceeding

Publication Date

8-1-2025

Publication Title

Am J Transplant

Abstract

Purpose: Liver transplant (LT) recipients undergoing Endoscopic retrograde cholangiopancreatography (ERCP) represent a unique patient group that faces distinct challenges during ERCP. This study aims to assess the risk of post-ERCP complications in LT patients. Methods: A retrospective cohort study using the TriNetX US Collaborative Network identified LT patients who underwent ERCP and compared them to a matched non-LT group. The primary outcome was post-ERCP pancreatitis. Secondary outcomes included bleeding, cholangitis, sepsis, transfusion need, and mortality. Results: A total of 3,032 patients were identified in the LT group (group 1), and 126,056 in the no LT group (group 2). The mean age in group 1 was 56.7 +/- 12.1, and 57.7+/- 17.9 in group 2. Females were 982 in group 1, and 66,482 in group 2. Propensity score matching was performed on all baseline characteristics that can be potential confounders, including age, sex, race, and co-morbidities. (Table 1) The outcome analysis after matching showed the incidence of acute pancreatitis post-ERCP was 1.3% in LT group compared to 1.7% in the non-LT group, however it was not statistically significant (RR = 0.770; CI = 0.480 - 1.235, p = 0.277). There was no statistically significant difference in rates of cholangitis (5.5% in LT vs. 4.3% in no LT, RR=1.293, CI=0.980-1.707, p=0.068), sepsis (2.8% vs. 1.8%, RR=1.550, CI=0.996-2.412, p=0.050), gastrointestinal bleeding (1.1% vs. 1%, RR=1.105; CI=0.605-2.019, p=0.745) or mortality (0.4% vs. 0.4%, RR=0.999, CI=0.416-2.396, p=0.998). (Table 2) Conclusions: Liver transplant patients undergoing ERCP exhibited a short-term safety profile similar to that of the general population, particularly in the risk of acute pancreatitis. These findings highlight the safety of ERCP in post liver transplant patients despite being on chronic immunosuppression. [Formula presented] CITATION INFORMATION: Abusuliman M., Ismail A., Elfert K., Abusuliman A., Eldesouki M., Cox T., Amreia M., Elsaka H., Ali M., Estrada P., Elhanafi S. Safety of Endoscopic Retrograde Cholangiopancreatography (ERCP) in Liver Transplant Patients: A Population-Based Propensity-Matched Study AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: M. Abusuliman: None.

Volume

25

Issue

8 Supplement 1

First Page

S455

Last Page

S456

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