scholarly journals Motion – Patients with Primary Sclerosing Cholangitis Should Undergo Early Liver Transplantation: Arguments for the Motion

2002 ◽  
Vol 16 (10) ◽  
pp. 697-699 ◽  
Author(s):  
Young-Mee Lee
Keyword(s):  
Liver Transplantation ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Survival Rates ◽  
Biliary Tree ◽  
Unknown Etiology ◽  
Dismal Prognosis ◽  
History Of ◽  
End Stage ◽  
Extrahepatic Biliary Tree

Primary sclerosing cholangitis (PSC) is a condition of unknown etiology that causes progressive inflammation, fibrosis and obliteration of the intrahepatic and extrahepatic biliary tree. There is no medical cure, and ursodeoxycholic acid and other drugs have not been shown to affect the natural history of the disease. Endoscopic dilation is of value only in the relief of symptoms and complications related to dominant strictures. Cholangiocarcinoma occurs in a substantial minority of cases, especially those with ulcerative colitis and cirrhosis, and is often not clinically apparent before surgery. There are no good serologic tests for early cancers. Because this tumour has such a dismal prognosis, some authorities recommend that liver transplantation be undertaken before its development. This procedure is the only curative option for PSC, and excellent survival rates have been reported. There is evidence that early transplantation, before end stage liver disease or cholangiocarcinoma have developed, improves the survival and quality of life of patients with PSC. Because it is the only procedure of proven benefit, patients with PSC should be considered for liver transplantation early in the course of the disease.

scholarly journals Successful Treatment of Recurrent Primary Sclerosing Cholangitis after Orthotopic Liver Transplantation with Oral Vancomycin

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Yinka K. Davies ◽  
Cynthia J. Tsay ◽  
Dario V. Caccamo ◽  
Kathleen M. Cox ◽  
Ricardo O. Castillo ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Liver Transplantation ◽  
Primary Sclerosing Cholangitis ◽  
Orthotopic Liver Transplantation ◽  
Successful Treatment ◽  
Sclerosing Cholangitis ◽  
Bile Ducts ◽  
Biliary Tree ◽  
Oral Vancomycin ◽  
Inflammatory Bowel

Primary sclerosing cholangitis (PSC) is a progressive, cholestatic disease of the liver that is marked by inflammation of the bile ducts and damage to the hepatic biliary tree. Approximately 60–70% of patients also have inflammatory bowel disease and progression of PSC can lead to ulcerative colitis and cirrhosis of the liver. Due to limited understanding of the etiology and mechanism of PSC, the only existing treatment option is orthotopic liver transplantation (OLT); however, recurrence of PSC, after OLT is estimated to be between 5% and 35%. We discuss the successful treatment of a pediatric patient, with recurrent PSC, after OLT with oral Vancomycin.

scholarly journals Sa1022 Natural History of Inflammatory Bowel Disease Post Liver Transplantation for Primary Sclerosing Cholangitis

2014 ◽  
Vol 146 (5) ◽  
pp. S-939-S-940
Author(s):  
Shiva K. Ratuapli ◽  
Jonathan A. Leighton ◽  
Shabana F. Pasha ◽  
David D. Douglas ◽  
Suryakanth Gurudu ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Liver Transplantation ◽  
Natural History ◽  
Primary Sclerosing Cholangitis ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
History Of ◽  
Inflammatory Bowel

Timing, Management, and Outcomes of Liver Transplantation in Primary Sclerosing Cholangitis

2017 ◽  
Vol 37 (04) ◽  
pp. 305-313 ◽  
Author(s):  
Cynthia Levy ◽  
Eric Martin
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Primary Sclerosing Cholangitis ◽  
Graft Survival ◽  
Sclerosing Cholangitis ◽  
Cholestatic Liver Disease ◽  
Biliary Cirrhosis ◽  
Immune Mediated ◽  
End Stage ◽  
Patient And Graft Survival

AbstractPrimary sclerosing cholangitis (PSC) is a chronic, immune-mediated cholestatic liver disease that often progresses to secondary biliary cirrhosis and end-stage liver disease. Short of liver transplantation (LT), there is no effective treatment for PSC. PSC accounts for approximately 5% of total adult LTs in the US and is currently the fifth most common indication for LT. Patient and graft survival for PSC is among the highest for all indications for LT. The main factors that impact outcomes after LT for PSC include biliary strictures, rejection, and recurrence of PSC. Recurrent PSC (rPSC) develops in 20% of LT recipients within 5 years of LT and is associated with negative patient and graft survival. LT is a viable option for recipients who develop rPSC and progress to graft failure.

scholarly journals Outcome stagnation of liver transplantation for primary sclerosing cholangitis in the Model for End-Stage Liver Disease era

2014 ◽  
Vol 399 (8) ◽  
pp. 1021-1029 ◽  
Author(s):  
Johannes Klose ◽  
Michelle A. Klose ◽  
Courtney Metz ◽  
Frank Lehner ◽  
Michael P. Manns ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center

2020 ◽  
Vol 9 (11) ◽  
pp. 3685
Author(s):  
Julian M. O. Pohl ◽  
Nathanael Raschzok ◽  
Dennis Eurich ◽  
Michael Pflüger ◽  
Leke Wiering ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Resection ◽  
Survival Rates ◽  
High Volume ◽  
Biliary Tree ◽  
Lymphoproliferative Disease ◽  
Meld Score ◽  
Liver Resections ◽  
Liver Transplantations ◽  
End Stage

Although more than one million liver transplantations have been carried out worldwide, the literature on liver resections in transplanted livers is scarce. We herein report a total number of fourteen patients, who underwent liver resection after liver transplantation (LT) between September 2004 and 2017. Hepatocellular carcinomas and biliary tree pathologies were the predominant indications for liver resection (n = 5 each); other indications were abscesses (n = 2), post-transplant lymphoproliferative disease (n = 1) and one benign tumor. Liver resection was performed at a median of 120 months (interquartile range (IQR): 56.5–199.25) after LT with a preoperative Model for End-Stage Liver Disease (MELD) score of 11 (IQR: 6.75–21). Severe complications greater than Clavien–Dindo Grade III occurred in 5 out of 14 patients (36%). We compared liver resection patients, who had a treatment option of retransplantation (ReLT), with actual ReLTs (excluding early graft failure or rejection, n = 44). Bearing in mind that late ReLT was carried out at a median of 117 months after first transplantation and a median of MELD of 32 (IQR: 17.5–37); three-year survival following liver resection after LT was similar to late ReLT (50.0% vs. 59.1%; p = 0.733). Compared to ReLT, liver resection after LT is a rare surgical procedure with significantly shorter hospital (mean 25, IQR: 8.75–49; p = 0.034) and ICU stays (mean 2, IQR: 1–8; p < 0.001), acceptable complications and survival rates.

scholarly journals Natural History of Established and De Novo Inflammatory Bowel Disease After Liver Transplantation for Primary Sclerosing Cholangitis

2018 ◽  
Vol 24 (5) ◽  
pp. 1074-1081 ◽  
Author(s):  
Mohamad A Mouchli ◽  
Siddharth Singh ◽  
Lisa Boardman ◽  
David H Bruining ◽  
Amy L Lightner ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Liver Transplantation ◽  
Natural History ◽  
Primary Sclerosing Cholangitis ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
De Novo ◽  
History Of ◽  
Inflammatory Bowel
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