Recurrence of primary sclerosing cholangitis after liver transplantation - The Hungarian experience

被引:13
作者
Gelley, Fanni [1 ]
Zadori, Gergely [1 ]
Gorog, Denes [1 ]
Kobori, Laszlo [1 ]
Fehervari, Imre [1 ]
Gaman, Gyorgy [1 ]
Gerlei, Zsuzsanna [1 ]
Nagy, Peter [2 ]
Sarvary, Eniko [1 ]
Nemes, Balazs [1 ]
机构
[1] Semmelweis Univ, Dept Transplantat & Surg, Budapest, Hungary
[2] Semmelweis Univ, Dept Pathol & Expt Canc Res 2, Budapest, Hungary
关键词
disease recurrence; inflammatory bowel disease; liver transplantation; primary sclerosing cholangitis;
D O I
10.1556/IMAS.6.2014.1.2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Recurrence of primary sclerosing cholangitis (rPSC) after liver transplantation (OLT) significantly affects longterm graft survival. We aimed to evaluate the incidence of rPSC and clinical data of these patients in Hungary. Patients and Methods: We retrospectively analyzed data of 511 whole liver transplantations from 1995 to 2011. During the study period, 49 OLTs were performed in 43 adult patients with end-stage PSC (10%). Results: Out of 49 OLT, 24 cases were excluded, rPSC was diagnosed in six patients (12%). Patients with rPSC had significantly higher mortality (p = 0.009) and graft loss (p = 0.009) in comparison to patients without recurrent disease. Younger recipient age, higher donor BMI was observed in the rPSC group. One patient was diagnosed with de novo IBD, the remaining five patients had worsening IBD activity in the posttransplant period. PreOLT colectomy was performed in 21% of the control and none of the rPSC group. PostOLT colectomy was performed in two rPSC patients due to severe therapy resistant colitis. Conclusions: Recurrent PSC signifi cantly affects long-term mortality and graft loss. Younger age at OLT, higher donor BMI and severe active IBD may be associated with PSC recurrence. PreOLT total colectomy might have protective effect against rPSC.
引用
收藏
页码:16 / 18
页数:3
相关论文
共 10 条
[1]   Immunology of the gut and liver: a love/hate relationship [J].
Adams, D. H. ;
Eksteen, B. ;
Curbishley, S. M. .
GUT, 2008, 57 (06) :838-848
[2]   A Re-Evaluation of the Risk Factors for the Recurrence of Primary Sclerosing Cholangitis in Liver Allografts [J].
Alabraba, Edward ;
Nightingale, Peter ;
Gunson, Bridget ;
Hubscher, Stefan ;
Olliff, Simon ;
Mirza, Darius ;
Neuberger, James .
LIVER TRANSPLANTATION, 2009, 15 (03) :330-340
[3]   Clinically recurrent primary sclerosing cholangitis following liver transplantation: A time course [J].
Campsen, Jeffrey ;
Zimmerman, Michael A. ;
Troffer, James F. ;
Wachs, Michael ;
Bak, Thomas ;
Steinberg, Tracy ;
Kam, Lgal .
LIVER TRANSPLANTATION, 2008, 14 (02) :181-185
[4]   Recurrence and rejection in liver transplantation for primary sclerosing cholangitis [J].
Fosby, Bjarte ;
Karlsen, Tom H. ;
Melum, Espen .
WORLD JOURNAL OF GASTROENTEROLOGY, 2012, 18 (01) :1-15
[5]   Activity of Ulcerative Colitis Before and After Liver Transplantation in Primary Sclerosing Cholangitis: The Hungarian Experience [J].
Gelley, F. ;
Miheller, P. ;
Peter, A. ;
Telkes, G. ;
Nemes, B. .
TRANSPLANTATION PROCEEDINGS, 2012, 44 (07) :2164-2165
[6]   Recurrence of primary sclerosing cholangitis following liver transplantation [J].
Graziadei, IW ;
Wiesner, RH ;
Batts, KP ;
Marotta, PJ ;
LaRusso, NF ;
Porayko, MK ;
Hay, JE ;
Gores, GJ ;
Charlton, MR ;
Ludwig, J ;
Poterucha, JJ ;
Steers, JL ;
Krom, RAF .
HEPATOLOGY, 1999, 29 (04) :1050-1056
[7]   Update on primary sclerosing cholangitis [J].
Karlsen, Tom H. ;
Schrumpf, Erik ;
Boberg, Kirsten M. .
DIGESTIVE AND LIVER DISEASE, 2010, 42 (06) :390-400
[8]   Liver transplantation for primary sclerosing cholangitis: A long-term clinicopathologic study [J].
Khettry, U ;
Keaveny, A ;
Goldar-Najafi, A ;
Lewis, WD ;
Pomfret, EA ;
Pomposelli, JJ ;
Jenkins, RL ;
Gordon, FD .
HUMAN PATHOLOGY, 2003, 34 (11) :1127-1136
[9]   Recurrence of primary sclerosing cholangitis in patients after liver transplantation [J].
Oldakowska-Jedynak, U ;
Nowak, M ;
Mucha, K ;
Foroncewicz, B ;
Nyckowski, P ;
Zieniewicz, K ;
Ziarkiewicz-Wróblewska, B ;
Patkowski, W ;
Górnicka, B ;
Paczkowska, A ;
Michalowicz, B ;
Pilecki, T ;
Pawlak, J ;
Krawczyk, M ;
Paczek, L .
TRANSPLANTATION PROCEEDINGS, 2006, 38 (01) :240-243
[10]   Risk factors for recurrence of primary sclerosing cholangitis of liver allograft [J].
Vera, A ;
Moledina, S ;
Gunson, B ;
Hubscher, S ;
Mirza, D ;
Olliff, S ;
Neuberger, J .
LANCET, 2002, 360 (9349) :1943-1944