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Recurrence of primary biliary cirrhosis after orthotopic liver transplantation
Roland Kurdow1, Hans-Guenther Marks, Heike Kraemer-Hansen
1Clinic for General and Thoracic Surgery, University Clinic, Christian Albrechts University, Arnold-Heller Str. 7, 24105 Kiel, Germany. rkurdow@surgery.uni-kiel.de
Background/Aims:
The incidence of graft failure due to recurrence of primary biliary cirrhosis after liver transplantation and the clinical value of histological and serological parameters indicating a recurrence are still discussed controversially in the literature.
Methodology:
In a retrospective study 18 patients who had received orthotopic liver grafts for primary biliary cirrhosis were investigated for recurrence of disease. Histological findings, the appearance of primary biliary cirrhosis associated autoimmune diseases, the course of antimitochondrial antibodies, serological parameters of liver function and HLA status were evaluated.
Results:
During a median follow-up period of 114 months, 6 of 18 patients developed a recurrence of primary biliary cirrhosis as indicated by liver biopsies, one patient developed clinical graft failure together with histological recurrence. Twelve patients developed autoimmune diseases. Antimitochondrial antibodies were present in all patients within a period of 12 months after transplantation. Serological parameters were elevated in 16 of 18 patients. Histological findings, serological parameters and associated diseases did not correlate with each other and with clinical symptoms of primary biliary cirrhosis recurrence.
Conclusions:
Graft failure due to recurrent disease can occur, but, despite a follow-up period of nearly 10 years, it is not possible to define predictive factors on the basis of histology or serology.