Liver transplantation for primary sclerosing cholangitis--a single-center experience

The purpose of this study was to analyze the outcome of liver transplantation for primary sclerosing cholangitis (PSC) at our center. The medical records of 47 consecutive patients transplanted during the period 1985-1996 were reviewed. Actuarial patient survival was determined at 1, 5, and 10 years. Data on reasons for retransplantation, incidental carcinoma, biliary complications that required surgical intervention, and signs of possible disease recurrence were collected. The median follow-up period was 3.6 years. Overall patient survival was 75% at 1 year and 66% at 5 and 10 years. Patients transplanted during the period 1994-1996 (n = 24) had a significantly (P < 0.02) better 1 year (88% vs 61%) and 5-year (83% vs 48%) survival than patients transplanted during the period 1985-1993 (n = 23). Six patients (13%) were retransplanted, and 4 are currently alive. Nine patients (19%) had biliary complications that required surgical intervention. Cholangiocellular carcinoma was found in 4 (9%) explanted livers, and all 4 patients succumbed within 2 years of transplantation. Indications of disease recurrence were seen in 4 patients (9%). In conclusion, the results of liver transplantation for PSC at our center are comparable to those of other benign indications, but a relatively high incidence of biliary complications was noted, and a possible disease recurrence was detected in 9% of patients.