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Recurrent primary biliary cirrhosis: Peritransplant factors and ursodeoxycholic acid treatment post‐liver transplant
Author(s) -
Guy Jennifer E.,
Qian Peiqing,
Lowell Jeffrey A.,
Peters Marion G.
Publication year - 2005
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20511
Subject(s) - medicine , ursodeoxycholic acid , primary biliary cirrhosis , gastroenterology , liver transplantation , asymptomatic , immunosuppression , liver biopsy , biopsy , elevated alkaline phosphatase , population , alkaline phosphatase , transplantation , biochemistry , chemistry , environmental health , enzyme
Abstract Primary biliary cirrhosis (PBC) recurs after orthotopic liver transplantation (OLT) in up to one‐third of patients. These patients are typically asymptomatic, can be identified by abnormal liver biochemistries, and have evidence of histologic recurrence on liver biopsy. The effect of treatment on recurrence has not been determined. This pilot study evaluates the factors associated with recurrent PBC and describes our experience using ursodeoxycholic acid treatment in this patient population. Forty‐eight patients with PBC were followed for at least 1 yr post‐OLT, and 27 patients (56%) developed abnormal serum alkaline phosphatase. Seventeen patients (35%) had evidence of recurrent PBC by liver biopsy. Patients with recurrent PBC had a trend toward longer warm ischemia times and more episodes of acute cellular rejection in the first year posttransplant, but this was not significant in multivariate analysis. Donor or recipient age, donor and recipient cytomegalovirus status, and dose of immunosuppression did not correlate with recurrence of PBC. Those patients diagnosed with recurrent PBC were placed on ursodeoxycholic acid, 15 mg/kg daily, with improvement in serum alkaline phosphatase in the majority. In conclusion, recurrent PBC is not infrequent post‐OLT, and ursodeoxycholic acid can be used with some benefit post‐OLT. Treatment effects on long‐term survival are not known. (Liver Transpl 2005;11:1252–1257.)