✦ LIBER ✦

Long-term survival and impact of ursodeoxycholic acid treatment for recurrent primary biliary cirrhosis after liver transplantation

✍ Scribed by Phunchai Charatcharoenwitthaya; Sylvania Pimentel; Jayant A. Talwalkar; Felicity T. Enders; Keith D. Lindor; Ruud A.F. Krom; Russell H. Wiesner

Publisher: John Wiley and Sons
Year: 2007
Tongue: English
Weight: 275 KB
Volume: 13
Category: Article
ISSN: 1527-6465
DOI: 10.1002/lt.21124

No coin nor oath required. For personal study only.

✦ Synopsis

The recurrence of primary biliary cirrhosis (PBC) in the hepatic allograft may impact patient and graft survival with long-term follow-up. The efficacy of ursodeoxycholic acid (UDCA) for treatment of recurrent PBC after liver transplantation (LT) remains less well known. The aims of this study were as follows: 1) to determine the significance of recurrent PBC on overall survival among PBC patients who underwent LT, and 2) to determine the efficacy of UDCA treatment after LT in patients with recurrent PBC. A retrospective cohort study was conducted of 154 PBC patients who underwent LT with at least 1 yr of follow-up after transplantation from 1985 through 2005. A total of 52 patients with recurrent PBC were identified. After adjusting for age and gender, recurrent PBC was not associated with death or liver retransplantation (hazard ratio, 0.97, 95% confidence interval, 0.41-2.31; P = 0.9). A total of 38 patients with recurrent PBC received UDCA at an average dose of 12 mg/kg/day for a mean duration of 55 months. Over a 36-month period, an estimated 52% of UDCA-treated patients experienced normalization of serum alkaline phosphatase and alanine aminotransferase compared to 22% of untreated patients. There was no significant difference in the rate of histological progression between subgroups. UDCA did not influence patient and graft survival. In conclusion, the development of recurrent PBC has little impact on long-term survival or need for retransplantation. While UDCA therapy is associated with biochemical improvement, its role in delaying histologic progression remains unknown. In this short period of treatment, UDCA was not associated with improved patient and graft survival compared to untreated patients.

📜 SIMILAR VOLUMES

Recurrent primary biliary cirrhosis: Per

Recurrent primary biliary cirrhosis: Peritransplant factors and ursodeoxycholic acid treatment post-liver transplant

✍ Jennifer E. Guy; Peiqing Qian; Jeffrey A. Lowell; Marion G. Peters 📂 Article 📅 2005 🏛 John Wiley and Sons 🌐 English ⚖ 184 KB

Primary biliary cirrhosis (PBC) recurs after orthotopic liver transplantation (OLT) in up to one-third of patients. These patients are typically asymptomatic, can be identified by abnormal liver biochemistries, and have evidence of histologic recurrence on liver biopsy. The effect of treatment on re

Is the Mayo model for predicting surviva

Is the Mayo model for predicting survival useful after the introduction of ursodeoxycholic acid treatment for primary biliary cirrhosis?

✍ M R Kilmurry; E J Heathcote; K Cauch-Dudek; K O'Rourke; R J Bailey; L M Blendis; 📂 Article 📅 1996 🏛 John Wiley and Sons 🌐 English ⚖ 165 KB 👁 1 views

Treatment of patients with primary biliary cirrhosis eral prognostic indicators have been proposed and (PBC) using ursodeoxycholic acid (UDCA) leads to a reprognostic indexes developed to predict survival. duction in serum bilirubin. The first objective of this Shapiro et al. 1 showed that serum bi

Does antimitochondrial antibody status a

Does antimitochondrial antibody status affect response to treatment in patients with primary biliary cirrhosis? Outcomes of ursodeoxycholic acid therapy and liver transplantation

✍ W R Kim; J J Poterucha; R A Jorgensen; K P Batts; H A Homburger; E R Dickson; R 📂 Article 📅 1997 🏛 John Wiley and Sons 🌐 English ⚖ 270 KB 👁 2 views

rum. 1 In the past decade, two treatment modalities have Approximately 5% to 10% of patients with features otherbeen shown to be effective in the treatment for PBC, dewise consistent with primary biliary cirrhosis (PBC) lack antipending on the stage of the disease. For patients with less mitochondri

Liver transplantation for HCV cirrhosis:

Liver transplantation for HCV cirrhosis: Improved survival in recent years and increased severity of recurrent disease in female recipients: Results of a long term retrospective study

✍ Luca S. Belli; Andrew K. Burroughs; Patrizia Burra; Alberto B. Alberti; Dimitrio 📂 Article 📅 2007 🏛 John Wiley and Sons 🌐 English ⚖ 297 KB 👁 1 views

In recent years, a worsening outcome of hepatitis C virus (HCV)-positive recipients and a faster progression of recurrent disease to overt cirrhosis has been reported. Our aims were to 1) assess patient survival and development of severe recurrent disease (Ishak fibrosis score > 3) in different tran