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Transplantation in primary biliary cirrhosis
R Sallie1, J O'Grady, R Williams
1Institute of Liver Studies, King's College Hospital, London, UK.
Journal of Gastroenterology and Hepatology
|November 1, 1991
Summary
Orthotopic liver transplantation (OLT) has improved survival rates for patients with end-stage primary biliary cirrhosis (PBC). Advances in care have significantly reduced early mortality, though long-term complications persist.
Area of Science:
- Hepatology
- Transplantation Immunology
- Gastroenterology
Background:
- End-stage primary biliary cirrhosis (PBC) is a leading indication for liver transplantation.
- Orthotopic liver transplantation (OLT) has become the preferred treatment for advanced PBC.
- Improvements in immunosuppression and postoperative care have enhanced patient survival.
Purpose of the Study:
- To evaluate the outcomes of OLT in patients with PBC.
- To assess survival rates and complications following OLT for PBC.
- To identify factors influencing OLT success in PBC patients.
Main Methods:
- Retrospective analysis of 129 patients with PBC undergoing OLT.
- Evaluation of survival data, operative mortality, and early postoperative mortality.
- Assessment of retransplantation rates and long-term complications.
Main Results:
- Overall 1 and 5-year survival rates were 65% and 63% respectively.
- Survival rates improved significantly for patients transplanted after 1985 (78% at 1 and 2 years).
- Early mortality decreased from 40% to 9% since 1988; 13% required retransplantation for vanishing bile duct syndrome.
Conclusions:
- OLT offers improved survival for end-stage PBC patients.
- Significant reductions in perioperative mortality have been achieved.
- Long-term complications, including metabolic bone disease and renal impairment due to cyclosporin toxicity, require ongoing management.