Research

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Here is an abstract I ran across on the web, FYI:

Hepatology 1999 Nov;30(5):1121-7

Long-term results of patients undergoing liver transplantation for primary

sclerosing cholangitis.

Graziadei IW, Wiesner RH, Marotta PJ, Porayko MK, Hay JE, Charlton MR,

Poterucha JJ, Rosen CB, Gores GJ, LaRusso NF, Krom RA

Liver Transplant Unit, Mayo Clinic, Rochester, MN 55905, USA.

Liver transplantation is the only effective therapeutic option for patients

with end-stage liver disease due to primary sclerosing cholangitis (PSC). In

this study, we analyzed a single center's experience with 150 consecutive

PSC patients who received 174 liver allografts. Mean follow-up was 55

months. Actuarial patient survival at 1, 2, 5, and 10 years was 93.7%,

92.2%, 86.4%, and 69.8%, respectively, whereas graft survival was 83.4%,

83.4%, 79.0%, and 60. 5%, respectively. The main indication for

retransplantation was hepatic artery thrombosis, and the major cause of

death was severe infection. Patients with PSC had a higher incidence of

acute cellular and chronic ductopenic rejection compared to a non-PSC

control group. Chronic ductopenic rejection adversely affected patient and

graft survival. Biliary strictures, both anastomotic and nonanastomotic,

were frequent and occurred in 16.2% and 27.2% of patients, respectively. The

incidence of recurrent PSC was 20%. A negative impact on patient survival

was not seen in patients with either postoperative biliary strictures or

recurrence of PSC. Six patients (4%) had cholangiocarcinoma and 1 patient

died related to recurrence of malignant disease. Seventy-eight percent of

PSC patients had associated inflammatory bowel disease, most commonly

chronic ulcerative colitis, which did not adversely impact patient outcome

posttransplantation. Nine patients required proctocolectomy after liver

transplantation; 5 because of intractable symptoms related to inflammatory

bowel disease and 4 due to the development of colorectal

carcinoma/high-grade dysplasia. Our data show that liver transplantation

provides excellent long-term patient and graft survival for patients with

end-stage PSC.

PMID: 10534330, UI: 20004598