Liver Transplantation in Primary Sclerosing Cholangitis

Kristian Bjøro; Bjørn Brandsæter; Aksel Foss; Erik Schrumpf

doi:10.1055/s-2006-933565

Seminars in Liver Disease, Inhaltsverzeichnis

Semin Liver Dis 2006; 26(1): 069-079
DOI: 10.1055/s-2006-933565

Liver Transplantation in Primary Sclerosing Cholangitis

Kristian Bjøro¹ , Bjørn Brandsæter¹ , Aksel Foss² , Erik Schrumpf¹

¹Department of Medicine, Rikshospitalet, Oslo, Norway
²Department of Surgery, Rikshospitalet, Oslo, Norway

Abstract

ABSTRACT

Primary sclerosing cholangitis (PSC) represents an important indication for liver transplantation. Selection for and timing of liver transplantation is difficult due to the disease course and the frequent occurrence of hepatobiliary malignancies. Pretransplantation screening of malignancies is difficult, but brush cytology of the biliary ducts seems to represent a possibility for early detection of some cholangiocarcinomas. Patient and graft survivals following liver transplantation are good, with 1 year patient survival exceeding 90%. Survival is also satisfactory in patients with early detected or highly limited cholangiocarcinomas. Recurrent PSC represents a particular problem, and affects as many as 20 to 40% in a long-term perspective. Few predictors of recurrent disease have been identified; severe rejections and their treatment may be of importance.

KEYWORDS

Primary sclerosing cholangitis - liver transplantation - cholangiocarcinoma - recurrent disease

Volltext

Referenzen

REFERENCES

1 Adam R, McMaster P, O'Grady J G et al.. Evolution of liver transplantation in Europe: report of the European Liver Transplant Registry. Liver Transpl. 2003; 9 1231-1243
2 Nordic Liver Transplant Registry .Annual report 2004. http://Available at: www.scandiatransplant.org Accessed August 1, 2005
3 Stieber A C, Marino I R, Iwatsuki S, Starzl T E. Cholangiocarcinoma in sclerosing cholangitis. The role of liver transplantation. Int Surg. 1989; 74 1-3
4 The Organ Procurement and Transplantation Network .http://Available at: www.OPTN.org/latestData/rptData.asp Accessed December 31, 2004
5 Brandsaeter B, Broome U, Isoniemi H et al.. Liver transplantation for primary sclerosing cholangitis in the Nordic countries: outcome after acceptance to the waiting list. Liver Transpl. 2003; 9 961-969
6 Brandsaeter B, Friman S, Broomè U et al.. Outcome following liver transplantation for primary sclerosing cholangitis in the Nordic countries. Scand J Gastroenterol. 2003; 38 1176-1183
7 Boberg K M, Rocca G, Egeland T et al.. Time-dependent Cox regression model is superior in prediction of prognosis in primary sclerosing cholangitis. Hepatology. 2002; 35 652-657
8 Kim W R, Poterucha J J, Wiesner R H et al.. The relative role of the Child-Pugh classification and the Mayo natural history model in the assessment of survival in patients with primary sclerosing cholangitis. Hepatology. 1999; 29 1643-1648
9 Ricci P, Therneau T M, Malinchoc M et al.. A prognostic model for the outcome of liver transplantation in patients with cholestatic liver disease. Hepatology. 1997; 25(3) 672-677
10 Fausa O, Schrumpf E, Elgjo K. Relationship of inflammatory bowel disease and primary sclerosing cholangitis. Semin Liver Dis. 1991; 11 31-39
11 Okolicsanyi L, Fabris L, Viaggi S, Carulli N, Podda M, Ricci G. Primary sclerosing cholangitis: clinical presentation, natural history and prognostic variables: an Italian multicentre study. The Italian PSC Study Group. Eur J Gastroenterol Hepatol. 1996; 8 685-691
12 Takikawa H, Manabe T. Primary sclerosing cholangitis in Japan-analysis of 192 cases. J Gastroenterol. 1997; 32 134-137
13 Vera A, Moledina S, Gunson B et al.. Risk factors for recurrence of primary sclerosing cholangitis of liver allograft. Lancet. 2002; 360 1943-1944
14 Vera A, Gunson B K, Ussatoff V et al.. Colorectal cancer in patients with inflammatory bowel disease after liver transplantation for primary sclerosing cholangitis. Transplantation. 2003; 75 1983-1988
15 Brandsaeter B, Isoniemi H, Broome U et al.. Liver transplantation for primary sclerosing cholangitis; predictors and consequences of hepatobiliary malignancy. J Hepatol. 2004; 40 815-822
16 Bergquist A, Ekbom A, Olsson R et al.. Hepatic and extrahepatic malignancies in primary sclerosing cholangitis. J Hepatol. 2002; 36 321-327
17 Leidenius M, Hockerstedt K, Broome U et al.. Hepatobiliary carcinoma in primary sclerosing cholangitis: a case control study. J Hepatol. 2001; 34 792-798
18 Buckles D C, Lindor K D, LaRusso N F, Petrovic L M, Gores G J. In primary sclerosing cholangitis, gallbladder polyps are frequently malignant. Am J Gastroenterol. 2002; 97 1138-1142
19 Mazzaferro V, Regalia E, Doci R et al.. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996; 334 693-699
20 Bruix J, Sherman M, Llovet J M et al.. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol. 2001; 35 421-430
21 Frezza E E, Mezghebe H. Gallbladder carcinoma: a 28 year experience. Int Surg. 1997; 82 295-300
22 Ahrendt S A, Pitt H A, Nakeeb A et al.. Diagnosis and management of cholangiocarcinoma in primary sclerosing cholangitis. J Gastrointest Surg. 1999; 3 357-367
23 Campbell W L, Ferris J V, Holbert B L, Thaete F L, Baron R L. Biliary tract carcinoma complicating primary sclerosing cholangitis: evaluation with CT, cholangiography, US, and MR imaging. Radiology. 1998; 207 41-50
24 Patt C HM, Thuluvath P JM. Liver transplantation for primary sclerosing cholangitis: screening for biliary malignancy and the role of preemptive transplantation. Curr Opin Organ Transplant. 2002; 7 129-136
25 Layfield L J, Cramer H. Primary sclerosing cholangitis as a cause of false positive bile duct brushing cytology: report of two cases. Diagn Cytopathol. 2005; 32 119-124
26 Brandsaeter B, Isoniemi H, Broome U et al.. Liver transplantation for primary sclerosing cholangitis; predictors and consequences of hepatobiliary malignancy. J Hepatol. 2004; 40 815-822
27 De Vreede I, Steers J L, Burch P A et al.. Prolonged disease-free survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma. Liver Transpl. 2000; 6 309-316
28 Sudan D, DeRoover A, Chinnakotla S et al.. Radiochemotherapy and transplantation allow long-term survival for nonresectable hilar cholangiocarcinoma. Am J Transplant. 2002; 2 774-779
29 Meyer C G, Penn I, James L. Liver transplantation for cholangiocarcinoma: results in 207 patients. Transplantation. 2000; 69 1633-1637
30 Wiesner R H, Porayko M K, Dickson E R et al.. Selection and timing of liver transplantation in primary biliary cirrhosis and primary sclerosing cholangitis. Hepatology. 1992; 16 1290-1299
31 Welsh F K, Wigmore S J. Roux-en-Y choledochojejunostomy is the method of choice for biliary reconstruction in liver transplantation for primary sclerosing cholangitis. Transplantation. 2004; 77 602-604
32 Olsson R, Bjornsson E, Backman L et al.. Bile duct bacterial isolates in primary sclerosing cholangitis: a study of explanted livers. J Hepatol. 1998; 28 426-432
33 Wiesner R H. Liver transplantation for primary sclerosing cholangitis: timing, outcome, impact of inflammatory bowel disease and recurrence of disease. Best Pract Res Clin Gastroenterol. 2001; 15 667-680
34 Tzakis A G, Gordon R D, Shaw Jr B W, Iwatsuki S, Starzl T E. Clinical presentation of hepatic artery thrombosis after liver transplantation in the cyclosporine era. Transplantation. 1985; 40 667-671
35 Merion R M, Burtch G D, Ham J M, Turcotte J G, Campbell D A. The hepatic artery in liver transplantation. Transplantation. 1989; 48 438-443
36 Goldstein R M, Secrest C L, Klintmalm G B, Husberg B S. Problematic vascular reconstruction in liver transplantation. Part I Arterial. Surgery. 1990; 107 540-543
37 Neuberger J. Incidence, timing, and risk factors for acute and chronic rejection. Liver Transpl Surg. 1999; 5(suppl 1) 30-36
38 Lerut J, Demetris A J, Stieber A C et al.. Intrahepatic bile duct strictures after human orthotopic liver transplantation. Recurrence of primary sclerosing cholangitis or unusual presentation of allograft rejection?. Transpl Int. 1988; 1 127-130
39 Porayko M K, Kondo M, Steers J L. Liver transplantation: late complications of the biliary tract and their management. Semin Liver Dis. 1995; 15 139-155
40 Feller R B, Waugh R C, Selby W S, Dolan P M, Sheil A G, McCaughan G W. Biliary strictures after liver transplantation: clinical picture, correlates and outcomes. J Gastroenterol Hepatol. 1996; 11 21-25
41 Neuberger J. Liver transplantation for cholestatic liver disease. Curr Treat Options Gastroenterol. 2003; 6 113-121
42 Graziadei I W, Wiesner R H, Batts K P et al.. Recurrence of primary sclerosing cholangitis following liver transplantation. Hepatology. 1999; 29 1050-1056
43 Harrison R F, Davies M H, Neuberger J M, Hubscher S G. Fibrous and obliterative cholangitis in liver allografts: evidence of recurrent primary sclerosing cholangitis?. Hepatology. 1994; 20 356-361
44 Jeyarajah D R, Netto G J, Lee S P et al.. Recurrent primary sclerosing cholangitis after orthotopic liver transplantation: is chronic rejection part of the disease process?. Transplantation. 1998; 66 1300-1306
45 Khettry U, Keaveny A, Goldar-Najafi A et al.. Liver transplantation for primary sclerosing cholangitis: a long-term clinicopathologic study. Hum Pathol. 2003; 34 1127-1136
46 Kubota T, Thomson A, Clouston A D et al.. Clinicopathologic findings of recurrent primary sclerosing cholangitis after orthotopic liver transplantation. J Hepatobiliary Pancreat Surg. 1999; 6 377-381
47 Kugelmas M, Spiegelman P, Osgood M J et al.. Different immunosuppressive regimens and recurrence of primary sclerosing cholangitis after liver transplantation. Liver Transpl. 2003; 9 727-732
48 Liden H, Norrby J, Friman S, Olausson M. Liver transplantation for primary sclerosing cholangitis-a single-center experience. Transpl Int. 2000; 13(S1) 62-64
49 MacLean A R, Lilly L, Cohen Z, O'Connor B, McLeod R S. Outcome of patients undergoing liver transplantation for primary sclerosing cholangitis. Dis Colon Rectum. 2003; 46 1124-1128
50 Narumi S, Roberts J P, Emond J C, Lake J, Ascher N L. Liver transplantation for sclerosing cholangitis. Hepatology. 1995; 22 451-457
51 Sheng R, Campbell W L, Zajko A B, Baron R L. Cholangiographic features of biliary strictures after liver transplantation for primary sclerosing cholangitis: evidence of recurrent disease. AJR Am J Roentgenol. 1996; 166 1109-1113
52 Yusoff I F, House A K, De Boer W B et al.. Disease recurrence after liver transplantation in Western Australia. J Gastroenterol Hepatol. 2002; 17 203-207
53 Goss J A, Shackleton C R, Farmer D G et al.. Orthotopic liver transplantation for primary sclerosing cholangitis. A 12-year single center experience. Ann Surg. 1997; 225 472-481
54 Brandsaeter B, Schrumpf E, Bentdal O et al.. Recurrent primary sclerosing cholangitis after liver transplantation: A magnetic resonance cholangiography study with analyses of predictive factors. Liver Transpl. 2005; 11(11) 1361-1369
55 Hiroyuki S, Hironori Y, Kiichi T et al.. Application of double-balloon endoscopy for afferent limb lesions of Roux-en-Y surgical anastomoses. Gastrointest Endosc. 2005; 61(suppl 5) AB238
56 Graziadei I W, Wiesner R H, Marotta P J et al.. Long-term results of patients undergoing liver transplantation for primary sclerosing cholangitis. Hepatology. 1999; 30 1121-1127
57 Papatheodoridis G V, Hamilton M, Mistry P K, Davidson B, Rolles K, Burroughs A K. Ulcerative colitis has an aggressive course after orthotopic liver transplantation for primary sclerosing cholangitis. Gut. 1998; 43 639-644
58 Dvorchik I, Subotin M, Demetris A J et al.. Effect of liver transplantation on inflammatory bowel disease in patients with primary sclerosing cholangitis. Hepatology. 2002; 35 380-384
59 Haagsma E B, Van Den Berg A P, Kleibeuker J H, Slooff M J, Dijkstra G. Inflammatory bowel disease after liver transplantation: the effect of different immunosuppressive regimens. Aliment Pharmacol Ther. 2003; 18 33-44
60 Broome U, Lofberg R, Veress B, Eriksson L S. Primary sclerosing cholangitis and ulcerative colitis: evidence for increased neoplastic potential. Hepatology. 1995; 22 1404-1408

Kristian BjøroM.D. Ph.D.

Department of Medicine, Rikshospitalet

0027 Oslo, Norway

eMail: kristian.bjoro@rikshospitalet.no