Clinical significance of recurrent primary biliary cirrhosis after liver transplantation

Transplant International : Official Journal of the European Society for Organ Transplantation
M KnoopP Neuhaus

Abstract

Primary biliary cirrhosis (PBC) represents a classic indication for orthotopic liver transplantation (OLT); as an autoimmune disease, however, the existence and incidence of recurrent PBC is a matter of significant controversy. Between September 1988 and September 1994 a total of 544 OLTs was performed at our institution. Forty-nine patients (40 female) with a median age of 50.5 years and previous surgery in 36.4%, received a liver graft for PBC. The mean serum bilirubin level was 8.9 mg/dl (range 0.7-29.7). Immunosuppression was commenced as a cyclosporine A-based quadruple therapy or with FK 506 and prednisolone. Protocol liver biopsies were taken at defined intervals posttransplant. Two patients died due to Legionella pneumonia and hypoxic brain damage 2 and 8 weeks after OLT, resulting in an actuarial 5-year survival rate of 95% with 47/49 patients being alive compared to 83.5% of all other liver recipients. Evidence of recurrence of PBC, as defined by elevated cholestatic parameters and histological features of PBC, was found in four patients, another five patients showed only histological signs. Recurrence of PBC, which might compromise the long-term outcome after OLT, was suspected in 4/47 patients (8.5%). This evidence ...Continue Reading

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Citations

Oct 31, 2009·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jean-Charles Duclos-Vallee, Mylène Sebagh
Sep 8, 2000·Baillière's Best Practice & Research. Clinical Gastroenterology·J Neuberger
Oct 4, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Pamela B SylvestreRussell H Wiesner
Oct 2, 2001·Transplantation·Y SugawaraH Imamura
Jun 5, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·James Neuberger
Jun 27, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Josh LevitskyHelen S Te
Oct 13, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Manjushree GautamVijayan Balan
Sep 1, 2007·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Phunchai CharatcharoenwitthayaRussell H Wiesner
May 8, 2008·The American Journal of Surgical Pathology·Susan C AbrahamAlyssa M Krasinskas
Oct 20, 2012·Expert Review of Clinical Immunology·Shishir ShettyStefan G Hubscher

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