Outcome of Patients Undergoing Liver Transplantation for Primary Sclerosing Cholangitis

MacLean, Anthony R.; Lilly, Les; Cohen, Zane; O’Connor, Brenda I.; McLeod, Robin S.

doi:10.1007/s10350-004-7291-9

Cited by 36 publications

(14 citation statements)

References 34 publications

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“…32 Previous studies, however, have been contradictory and reported a favorable as well as a more aggressive course of IBD in PSC patients after liver transplantation. 5,[32][33][34][35] These studies compared IBD activity before and after transplantation in the same patients and may not be directly comparable to the present cross-sectional study of two parallel patient cohorts.…”

Section: Discussioncontrasting

confidence: 48%

Inflammatory bowel disease in patients with primary sclerosing cholangitis: Clinical characterization in liver transplanted and nontransplanted patients

Jørgensen

Grzyb

Lundin

et al. 2012

Inflammatory Bowel Diseases

113

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Section: Discussioncontrasting

confidence: 48%

Inflammatory bowel disease in patients with primary sclerosing cholangitis: Clinical characterization in liver transplanted and nontransplanted patients

Jørgensen

Grzyb

Lundin

et al. 2012

Inflammatory Bowel Diseases

113

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“…However the natural history of UC following liver transplantation is variable [68][69][70][71][72] . One study showed approximately a third had improvement in colitis, a third remained unchanged and a third suffered increased activity of colonic disease [73] . Several series report increased rates of colon cancer and colectomy after liver transplantation [74][75][76] .…”

Section: Psc Treatmentmentioning

confidence: 99%

Primary sclerosing cholangitis, autoimmune hepatitis and overlap syndromes in inflammatory bowel disease

Saich¹,

Chapman²

2008

WJG

117

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(AIH) is also more prevalent in patients with IBD, with up to 16% of patients with AIH also having ulcerative colitis. A small subgroup of patients have a AIH-PSC overlap syndrome and the management of these patients depends on liver histology, serum IgM levels, autoantibodies, degree of biochemical cholestasis and cholangiography as some of these patients may respond to immunosupression. INTRODUCTIONThe first association between colonic ulceration and liver disease was made in 1874 by Thomas CH, who described a young man who died of a 'much enlarged, fatty liver in the presence of ulceration of the colon' [1] . The association was confirmed by James Lister in 1899, who reported a patient with ulcerative colitis and secondary diffuse hepatitis [2] . Over the next 100 years it has become well established that there is a close relationship between inflammatory bowel disease and various hepatobiliary disorders. These disorders are listed in Table 1. PRIMARY SCLEROSING CHOLANGITISFirst described by Smith and Loe in 1965 [3] Primary sclerosing cholangitis (PSC) is a chronic progressive disorder of unknown aetiology characterised by inflammation, fibrosis and stricture formation in medium and large sized ducts in the biliary tree [4,5] . Common symptoms include itch and lethargy although many patients (up to 45%) are asymptomatic, even with advanced disease [5] . The disease is strongly associated with Inflammatory Bowel Disease and may be detected as an incidental finding of a raised serum alkaline phosphatase. www.wjgnet.comRe b e c c a S a i c h , Ro g e r C h a p m a n , AbstractPrimary sclerosing cholangitis (PSC) is a chronic progressive disorder of unknown aetiology characterised by chronic inflammation and stricture formation of the biliary tree.

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“…Conflicting reports of IBD activity have been published regarding the impact of a liver transplant on patients with preexisting IBD [192][193][194][195][196]. Risk factors for worsening of preexisting IBD after liver transplant includes active bowel inflammation at the time of transplantation [193], short interval between diagnosis of IBD and transplant [193], cigarette smoking [197], Clostridium difficile infection [198] and use of Tacrolimus after transplant [191,193,199,200].…”

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

“…Risk factors for worsening of preexisting IBD after liver transplant includes active bowel inflammation at the time of transplantation [193], short interval between diagnosis of IBD and transplant [193], cigarette smoking [197], Clostridium difficile infection [198] and use of Tacrolimus after transplant [191,193,199,200]. The use of steroid or immunosuppressive agents prior to transplant does not predict post-transplant IBD activity [194,195]. Steroids, Azathioprine and Cyclosporine should be preferred in these subgroup of patients [94,193,[199][200][201].…”

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

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Disorders of the liver and the biliary tract are frequently the extraintestinal manifestations of inflammatory bowel disease (IBD). The etiology of these hepato-biliary conditions is deemed secondary to their shared pathogenesis, the chronic effects of a long term, ongoing inflammation of the bowels, along with the medications used to manage IBD. For up to 30% of patients with IBD, abnormal liver biochemical tests are present. Other, selected patients with IBD are followed for reactivation of hepatitis B, through guidelines only relatively recently in place. The vast realm of related clinical conditions does not always correspond well with IBD severity, which can range from mild hepatic insult to end-stage liver disease, necessitating liver transplantation. Hence it is critical to follow its presence, clinical course and long term consequences. Moreover, the management of these disorders is necessarily individualized, with some patients requiring frequent monitoring and others a more multi-disciplinary approach. Studies aimed at improving the outcomes of patients with IBD who experience associated liver and biliary tract disorders are now needed to assess early identification, possible screening approaches and more effective systems of referral. This article covers the evidence-based literature on topics detailing the co-existence of liver conditions in inflammatory bowel disease with a focus on its epidemiology, clinical manifestations, diagnosis and management.

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Outcome of Patients Undergoing Liver Transplantation for Primary Sclerosing Cholangitis

Cited by 36 publications

References 34 publications

Inflammatory bowel disease in patients with primary sclerosing cholangitis: Clinical characterization in liver transplanted and nontransplanted patients

Inflammatory bowel disease in patients with primary sclerosing cholangitis: Clinical characterization in liver transplanted and nontransplanted patients

Primary sclerosing cholangitis, autoimmune hepatitis and overlap syndromes in inflammatory bowel disease

A review of liver disorders in inflammatory bowel disease (IBD)

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