Recurrence of primary sclerosing cholangitis in patients after liver transplantation

Transplant Proc. Jan-Feb 2006;38(1):240-3. doi: 10.1016/j.transproceed.2005.12.026.

Abstract

Background: Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease that progresses to end-stage liver disease. There are several specific problems related to the posttransplantation period in these patients. The aim of this study was to analyze a single center experience with 17 orthotopic liver transplantations (OLT) due to PSC.

Patients and methods: Seventeen patients were included (10 men, 7 women). Actuarial patient and graft survival rates and the incidence of recurrent sclerosing cholangitis were determined at 1, 5, and 7 years.

Results: Fifteen patients received single grafts, whereas two patients required retransplants. Patients received either cyclosporine (n = 7) or tacrolimus (n = 10) based immunosuppression. The 1-, 5-, and 7-year patient survival rates were 80%, 60%, and 60%, respectively, whereas the graft survival rates were 88%, 65%, and 65%, respectively. Two patients had cholangiocarcinomas (CCA) diagnosed during OLT; both recurred within 6 months and had a fatal outcome. Two patients (12%) developed recurrent sclerosing cholangitis, as assessed by liver histology and imaging of biliary tree.

Conclusions: Liver transplantation provides good patient and graft survival rates in cases affected with PSC. CCA is associated with poor recipient survival. Recurrent PSC occurs in approximately 12% of cases but does not significantly affect patient survival.

MeSH terms

  • Adult
  • Bile Duct Neoplasms / surgery
  • Cholangiocarcinoma / surgery
  • Cholangitis, Sclerosing / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Transplantation / mortality
  • Liver Transplantation / physiology*
  • Male
  • Middle Aged
  • Recurrence
  • Reoperation / statistics & numerical data
  • Survival Rate
  • Time Factors