Kirchner, Gabi I. and Scherer, Marcus N. and Obed, Aiman and Ruemmele, Petra and Wiest, Reiner and Froh, Matthias and Loss, Martin and Schlitt, Hans-Juergen and Schoelmerich, Juergen and Gelbmann, Cornelia M. (2011) Outcome of patients with ischemic-like cholangiopathy with secondary sclerosing cholangitis after liver transplantation. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 46 (4). pp. 471-478. ISSN 0036-5521,
Full text not available from this repository. (Request a copy)Abstract
Background and aims. Sclerosing cholangitis in critically ill patients (SC-CIP) with sepsis and acute respiratory distress syndrome (ARDS) is a cholestatic liver disease with a rapid progression to liver cirrhosis and hepatic failure. Data on outcome of these patients after liver transplantation (LT) are sparse. Patients and methods. Eleven patients (46 +/-+/- 12 years; mean labMELD-score: 27 +/-+/- 7) with SC-CIP underwent LT. Six patients had severe polytrauma with multiple bone fractures, sepsis and ARDS. Five non-traumatic patients acquired SC-CIP during long-term intensive-care-unit stays due to sepsis and ARDS. Time to diagnosis, the microbiologic results and the survival rates after LT were evaluated. Results. SC-CIP was diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) within 3 +/-+/- 1 months after manifestation of cholestasis and histologically confirmed in explanted livers. The predominant microorganisms isolated in bile were: Enterococcus and Candida albicans. Mean follow-up after LT was 28 +/-+/- 20 months. One female patient (non-traumatic) died due to sepsis 26 days after LT. All other patients left the hospital alive, but two (non-traumatic) patients died from sepsis, and one (traumatic) patient died in a hemorrhagic shock, thereafter. Seven of 11 patients (5 with polytrauma) are still alive and have a good quality of life. The survival of the SC-CIP patients after LT was comparable with that of patients transplanted due to alcoholic liver cirrhosis. Conclusion. SC-CIP develops rapidly within several months. Enterococcus and C. albicans were the main isolated microorganisms in the bile. Sepsis was the main cause of death after LT. Overall, SC-CIP is a good indication for LT in selected patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTENSIVE-CARE-UNIT; SEVERE TRAUMA; ILL PATIENTS; JAUNDICE; SHOCK; Cholestatic liver disease; liver transplantation; outcome; secondary sclerosing cholangitis; SC-CIP |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Pathologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Jun 2020 09:33 |
| Last Modified: | 23 Jun 2020 09:33 |
| URI: | https://pred.uni-regensburg.de/id/eprint/21090 |
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