Follow-up after liver transplantation for primary sclerosing cholangitis: Effects on survival, quality of life, and colitis

Background: Except for primary biliary cirrhosis, primary sclerosing cholangitis (PSC) is now the commonest indication for liver transplantation in Sweden. There are several specific problems related to post-transplantation life in these patients, Methods: We analyzed a 10-year cohort of 47 patients transplanted at our center. Results: Incidental biliary carcinoma was diagnosed in 13%, with a 2-year survival of only 17%, compared with 70% in the other patients. The 2-year survival has improved considerably (to 82%) in recent years. Quality of life was much or slightly improved in 80%. The colitis was much or slightly improved in 65%, with some deterioration in only 6%. No patient developed colonic carcinoma. Previous biliary tract surgery was identified as a risk factor for a worse 1-year mortality. Conclusions: Liver transplantation for PSC is now associated with a high survival rate and an improvement in the quality of life and course of ulcerative colitis. Previous biliary tract surgery is a risk factor for non-survival.