Hildebrand, Tatiana and Pannicke, Nadine and Dechene, Alexander and Gotthardt, Daniel N. and Kirchner, Gabriele and Reiter, Florian P. and Sterneck, Martina and Herzer, Kerstin and Lenzen, Henrike and Rupp, Christian and Barg-Hock, Hannelore and de Leuw, Philipp and Teufel, Andreas and Zimmer, Vincent and Lammert, Frank and Sarrazin, Christoph and Spengler, Ulrich and Rust, Christian and Manns, Michael P. and Strassburg, Christian P. and Schramm, Christoph and Weismueller, Tobias J. (2016) Biliary Strictures and Recurrence After Liver Transplantation for Primary Sclerosing Cholangitis: A Retrospective Multicenter Analysis. LIVER TRANSPLANTATION, 22 (1). pp. 42-52. ISSN 1527-6465, 1527-6473
Full text not available from this repository. (Request a copy)Abstract
Liver transplantation (LT) is the only definitive treatment for patients with end-stage liver disease due to primary sclerosing cholangitis (PSC), but a high rate of biliary strictures (BSs) and of recurrent primary sclerosing cholangitis (recPSC) has been reported. In this multicenter study, we analyzed a large patient cohort with a long follow-up in order to evaluate the incidence of BS and recPSC, to assess the impact on survival after LT, and to identify risk factors. We collected clinical, surgical, and laboratory data and records on inflammatory bowel disease (IBD), immunosuppression, recipient and graft outcome, and biliary complications (based on cholangiography and histology) of all patients who underwent LT for PSC in 10 German transplant centers between January 1990 and December 2006; 335 patients (68.4% men; mean age, 38.9 years; 73.5% with IBD) underwent transplantation 8.8 years after PSC diagnosis with follow-up for 98.8 months. The 1-, 5-, and 10-year recipient and graft survival was 90.7%, 84.8%, 79.4% and 79.1%, 69.0%, 62.4%, respectively. BS was diagnosed in 36.1% after a mean time of 3.9 years, and recPSC was diagnosed in 20.3% after 4.6 years. Both entities had a significant impact on longterm graft and recipient survival. Independent risk factors for BS were donor age, ulcerative colitis, chronic ductopenic rejection, bilirubin, and international normalized ratio (INR) at LT. Independent risk factors for recPSC were donor age, IBD, and INR at LT. These variables were able to categorize patients into risk groups for BS and recPSC. In conclusion, BS and recPSC affect longterm graft and patient survival after LT for PSC. Donor age, IBD, and INR at LTare independent risk factors for BS and recPSC and allow for risk estimation depending on the recipient-donor constellation. (C) 2015 AASLD.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SINGLE-CENTER EXPERIENCE; RISK-FACTORS; NATURAL-HISTORY; DISEASE; COMPLICATIONS; ALLOGRAFTS; REJECTION; LESIONS; MODEL; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Mar 2019 12:36 |
| Last Modified: | 07 Mar 2019 10:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/2229 |
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