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Chronologic changes of explanted liver volume and the use of ursodeoxycholic acid in patients with end‐stage primary biliary cirrhosis
Author(s) -
Tanaka Tomohiro,
Yamashiki Noriyo,
Sugawara Yasuhiko,
Tamura Sumihito,
Nakamura Minoru,
Kaneko Junichi,
Aoki Taku,
Sakamoto Yoshihiro,
Hasegawa Kiyoshi,
Kokudo Norihiro
Publication year - 2014
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12283
Subject(s) - ursodeoxycholic acid , medicine , gastroenterology , esophageal varices , primary biliary cirrhosis , liver transplantation , cirrhosis , portal hypertension , liver disease , stage (stratigraphy) , transplantation , paleontology , biology
Aim The clinical presentation of P rimary biliary cirrhosis ( PBC ) at the time of liver transplantation ( LT ) may have changed, due to the long‐term use of ursodeoxycholic acid ( UDCA ). The aim of this retrospective study was to investigate whether the clinical characteristics of LT recipients with PBC have changed over the years. Methods Of all 421 adults undergoing LT from 1997 to 2012 at our center, we included 85 recipients with PBC into the present study. The 85 recipients were divided into three groups according to the year LT was performed: group 1 (1997–2001, n = 29), group 2 (2002–2005, n = 29) and group 3 (2006–2012, n = 27). Results There were no significant differences in sex, recipient age, Model for End‐Stage Liver Disease score, updated Mayo risk score for PBC , or liver‐related complications except for esophageal varices among the three groups. Patients in group 1 were complicated with esophageal varices less frequently than those in the other two groups. In older cases, the ratio of explanted liver volume to standard liver volume ( ELV / SLV ) was significantly higher, and the duration of pre‐ LT UDCA treatment was significantly shorter. The duration of UDCA treatment was significantly correlated with ELV / SLV . Conclusion Recent LT patients were characterized by more frequent portal hypertension and more severe liver atrophy, with longer UDCA therapy prior to LT , which might have prevented the somewhat rapid progression of liver failure characterized by hepatomegaly with insignificant fibrosis or portal hypertension.