BACKGROUND: Primary sclerosing cholangitis (PSC) is a progressive cholestatic disorder with liver transplantation (LT) being the only definitive treatment in end-stage disease. Recurrence of PSC after LT is a significant concern which can lead to graft loss. The aim of this study is to find out the disease recurrence and long-term outcome after living donor liver transplantation (LDLT) in PSC. METHODS: We conducted a retrospective review of all patients undergoing LDLT for PSC at our centre. Of 2268 adult LTs from August 2004 to July 2018, 32 (1.4%) patients underwent LDLT for PSC including 6 with PSC and autoimmune hepatitis overlap. The data were reviewed to look for PSC recurrence, complications, and overall survival. All patients received tacrolimus-based immunosuppression. Data are shown as number, percentage, median, and interquartile range (IQR). RESULT: The mean age of 32 LDLT recipients was 44 ± 12 years (males 22, females 10). At the time of transplantation, the mean child's score was 9 ± 1.6 and model for end-stage liver disease score was 18.9 ± 6.4. Ulcerative colitis was seen in 7 patients and none had cholangiocarcinoma. Majority of patients (n = 29) received right lobe graft and all but 3 underwent hepaticojejunostomy for biliary reconstruction. PSC recurrence was seen in 6 (20%) patients during a median follow-up of 59 (29-101) months, after exclusion of 2 patients with early mortality. A total of five patients died during follow-up, and one of these deaths was due to PSC recurrence. There were 2 perioperative deaths due to sepsis and 3 deaths on follow-up (sepsis in 2 and PSC recurrence in 1). CONCLUSION: LDLT can be performed in PSC with good overall long-term outcomes.
BACKGROUND: Primary sclerosing cholangitis (PSC) is a progressive cholestatic disorder with liver transplantation (LT) being the only definitive treatment in end-stage disease. Recurrence of PSC after LT is a significant concern which can lead to graft loss. The aim of this study is to find out the disease recurrence and long-term outcome after living donor liver transplantation (LDLT) in PSC. METHODS: We conducted a retrospective review of all patients undergoing LDLT for PSC at our centre. Of 2268 adult LTs from August 2004 to July 2018, 32 (1.4%) patients underwent LDLT for PSC including 6 with PSC and autoimmune hepatitis overlap. The data were reviewed to look for PSC recurrence, complications, and overall survival. All patients received tacrolimus-based immunosuppression. Data are shown as number, percentage, median, and interquartile range (IQR). RESULT: The mean age of 32 LDLT recipients was 44 ± 12 years (males 22, females 10). At the time of transplantation, the mean child's score was 9 ± 1.6 and model for end-stage liver disease score was 18.9 ± 6.4. Ulcerative colitis was seen in 7 patients and none had cholangiocarcinoma. Majority of patients (n = 29) received right lobe graft and all but 3 underwent hepaticojejunostomy for biliary reconstruction. PSC recurrence was seen in 6 (20%) patients during a median follow-up of 59 (29-101) months, after exclusion of 2 patients with early mortality. A total of five patients died during follow-up, and one of these deaths was due to PSC recurrence. There were 2 perioperative deaths due to sepsis and 3 deaths on follow-up (sepsis in 2 and PSC recurrence in 1). CONCLUSION: LDLT can be performed in PSC with good overall long-term outcomes.
Authors: Roger Chapman; Johan Fevery; Anthony Kalloo; David M Nagorney; Kirsten Muri Boberg; Benjamin Shneider; Gregory J Gores Journal: Hepatology Date: 2010-02 Impact factor: 17.425
Authors: I W Graziadei; R H Wiesner; K P Batts; P J Marotta; N F LaRusso; M K Porayko; J E Hay; G J Gores; M R Charlton; J Ludwig; J J Poterucha; J L Steers; R A Krom Journal: Hepatology Date: 1999-04 Impact factor: 17.425
Authors: B Brandsaeter; S Friman; U Broomé; H Isoniemi; M Olausson; L Bäckman; B Hansen; E Schrumpf; A Oksanen; B G Ericzon; K Höckerstedt; H Mäkisalo; P Kirkegaard; K Bjøro Journal: Scand J Gastroenterol Date: 2003-11 Impact factor: 2.423
Authors: Jeffrey Campsen; Michael A Zimmerman; James F Trotter; Michael Wachs; Thomas Bak; Tracy Steinberg; Igal Kam Journal: Liver Transpl Date: 2008-02 Impact factor: 5.799
Authors: Fredric D Gordon; David S Goldberg; Nathan P Goodrich; Anna S F Lok; Elizabeth C Verna; Nazia Selzner; R Todd Stravitz; Robert M Merion Journal: Liver Transpl Date: 2016-08-02 Impact factor: 5.799