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Clinicopathologic findings of recurrent primary sclerosing cholangitis after orthotopic liver transplantation
Author(s) -
Kubota Toru,
Thomson Andrew,
Clouston Andrew D.,
Nakazawa Yuichi,
Steadman Charles,
Kerlin Paul,
Shimada Hiroshi,
Balderson Glenda A.,
Lynch Stephen V.,
Strong Russell W.
Publication year - 1999
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s005340050134
Subject(s) - medicine , primary sclerosing cholangitis , liver transplantation , surgery , transplantation , bile duct , radiological weapon , orthotopic liver transplantation , gastroenterology , disease
Whether primary sclerosing cholangitis (PSC) occurs after orthotopic liver transplantation is controversial, largely because the pre‐transplant diagnosis of PSC is based on nonspecific radiological and histological findings. We reviewed clinical, radiological, and histological records of 53 patients who underwent liver transplantation for PSC between 1985 and 1998. Three patients with patent hepatic arteries and no evidence of chronic rejection had radiological and histological findings that may have been due to recurrent PSC. Bile duct stricturing in these patients proved permanent and progressive and affected both the quality of life and graft survival. The first patient, who is 110 months after transplantation, has had repeated episodes of cholangitis for the last year. The second patient underwent excision of a strictured hepatic duct 45 months after transplantation and was ultimately retransplanted 95 months after initial transplantation. The third patient underwent left hemihepatectomy of an atrophied lobe 50 months after transplantation. Although the patient population assessed in this study is limited, putative recurrent PSC in the allografts has led either to graft loss or to clinically significant hepatobiliary complications of the graft.