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 25 May 2018

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Recurrence risk of primary sclerosing cholangitis after liver transplant

This month's Liver Transplantation identifies risk factors for recurrence of primary sclerosing cholangitis after liver transplantation.

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Liver transplantation is the only therapeutic option for end-stage primary sclerosing cholangitis.

However, primary sclerosing cholangitis can recur in some patients after liver transplantation.

Dr Evangelos Cholongitas and colleagues from the United Kingdom evaluated the risk factors associated with primary sclerosing cholangitis between 1989 and 2004.

The researchers assessed 69 patients receiving transplantation for primary sclerosing cholangitis, of which 42 were male with a mean age of 42 years.

Recurrent primary sclerosing cholangitis occurred in 14% of patients
Liver Transplantation

The team evaluated clinical and laboratory data, activity/extension and treatment of ulcerative colitis.

In addition, the team assessed post-liver transplantation cytomegalovirus infection, and immunosuppression.

Determination of recurrent primary sclerosing cholangitis was made by radiological and histological findings.

The researchers' exclusion criteria were ABO blood group incompatibility, hepatic artery stenosis, and biliary strictures occurring in less than 3 months post-liver transplantation.

The research team noted that 70% patients had primary sclerosing cholangitis and ulcerative colitis pre-liver transplantation.

The team observed that recurrent primary sclerosing cholangitis occurred in 14% of patients who were alive 1 year after liver transplantation.

No patient without post-liver transplantation ulcerative colitis had recurrent primary sclerosing cholangitis.

The researchers found that maintenance steroids for ulcerative colitis post-liver transplantation was the only risk factor significantly associated with recurrent primary sclerosing cholangitis.

Dr Cholongitas' team concluded, "The presence of ulcerative colitis post-liver transplantation, and the need for maintenance steroids post-liver transplantation, which is an independent factor, are associated with recurrent primary sclerosing cholangitis."

"These findings could help elucidate a possible mechanism of primary sclerosing cholangitis pathogenesis."

Liver Transplant 2008: 14(2): 138-43
07 February 2008

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