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Liver transplantation for primary sclerosing cholangitis; predictors and consequences of hepatobiliary malignancy.

Abstract：

BACKGROUND/AIMS:Hepatobiliary malignancies are frequently seen in primary sclerosing cholangitis (PSC) and they complicate the evaluation of patients and timing of liver transplantation. METHODS:Data from all Nordic PSC patients listed for liver transplantation during 1990-2001 were recorded prospectively. Predictors of hepatobiliary malignancy and patient survival rates have been analysed. RESULTS:Hepatobiliary malignancy was found in 52/255 (20%) patients accepted to the waiting list. Recent diagnosis of PSC, no ursodeoxycholic acid (UDCA) treatment, clinical suspicion and previous colorectal-cancer were predictors of malignancy. Among 89 patients with a strong suspicion of malignancy prior to acceptance, 35 (39%) had confirmed malignancy. A clinical suspicion had been raised in 35/52 (67%) patients with malignancy. Malignancy was found in 31/223 patients who received a liver allograft. The 1-, 3- and 5-year patient survival rates following transplantation for patients with PSC and cholangiocarcinoma were 65, 35 and 35%, respectively. CONCLUSIONS:Hepatobiliary malignancy is suspected in 1/3 of the PSC patients and found in 1/5. Although cholangiocarcinoma is regarded as a contraindication to liver transplantation (LTX), PSC patients with cholangiocarcinoma had a 35% 5-year survival following transplantation.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Brandsaeter B,Isoniemi H,Broomé U,Olausson M,Bäckman L,Hansen B,Schrumpf E,Oksanen A,Ericzon BG,Höckerstedt K,Mäkisalo H,Kirkegaard P,Friman S,Bjøro K

doi

10.1016/j.jhep.2004.01.002

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

815-22

issue

5

eissn

0168-8278

issn

1600-0641

pii

S0168827804000078

journal_volume

40

pub_type

杂志文章

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