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.

Primary sclerosing cholangitis

2010 ◽  
pp. 2468-2473
Author(s):  
R.W. Chapman ◽  
K.D. Williamson
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Weight Loss ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Close Association ◽  
Biliary Tree ◽  
Cholestatic Liver Disease ◽  
Immune Mediated ◽  
Inflammatory Bowel

Case History—A 60 yr old woman, known to have long standing colitis, now presenting with abdominal pain and weight loss. Primary sclerosing cholangitis is a chronic cholestatic liver disease caused by diffuse inflammation and fibrosis that can involve the entire biliary tree. The cause is unknown, but presumed to be immune mediated, and there is a very close association with inflammatory bowel disease, particularly ulcerative colitis....

scholarly journals Ulcerative colitis has an aggressive course after orthotopic liver transplantation for primary sclerosing cholangitis

Gut ◽  
1998 ◽  
Vol 43 (5) ◽  
pp. 639-644 ◽  
Author(s):  
G V Papatheodoridis ◽  
M Hamilton ◽  
P K Mistry ◽  
B Davidson ◽  
K Rolles ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Liver Transplantation ◽  
Primary Sclerosing Cholangitis ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
De Novo ◽  
Increased Risk ◽  
Inflammatory Bowel

Background—The course of inflammatory bowel disease after liver transplantation has been reported as variable with usually no change or improvement, but there may be an increased risk of early colorectal neoplasms. In many centres steroids are often withdrawn early after transplantation and this may affect inflammatory bowel disease activity.Aims—To evaluate the course of inflammatory bowel disease in primary sclerosing cholangitis transplant patients who were treated without long term steroids.Methods—Between 1989 and 1996, there were 30 patients transplanted for primary sclerosing cholangitis who survived more than 12 months. Ulcerative colitis was diagnosed in 18 (60%) patients before transplantation; two had previous colectomy. All patients underwent colonoscopy before and after transplantation and were followed for 38 (12–92) months. All received cyclosporin or tacrolimus with or without azathioprine as maintenance immunosuppression.Results—Ulcerative colitis course after transplantation compared with that up to five years before transplantation was the same in eight (50%) and worse in eight (50%) patients. It remained quiescent in eight and worsened in four of the 12 patients with pretransplant quiescent course, whereas it worsened in all four patients with pretransplant active course (p=0.08). New onset ulcerative colitis developed in three (25%) of the 12 patients without inflammatory bowel disease before transplantation. No colorectal cancer has been diagnosed to date.Conclusions—Preexisting ulcerative colitis often has an aggressive course, while de novo ulcerative colitis may develop in patients transplanted for primary sclerosing cholangitis and treated without long term steroids.

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