Liver transplantation for primary sclerosing cholangitis; predictors and consequences of hepatobiliary malignancy.

Abstract

BACKGROUND/AIMS:

Hepatobiliary malignancies are frequently seen in primary sclerosing cholangitis (PSC) and they complicate the evaluation of patients and timing of liver transplantation.

METHODS:

Data from all Nordic PSC patients listed for liver transplantation during 1990-2001 were recorded prospectively. Predictors of hepatobiliary malignancy and patient survival rates have been analysed.

RESULTS:

Hepatobiliary malignancy was found in 52/255 (20%) patients accepted to the waiting list. Recent diagnosis of PSC, no ursodeoxycholic acid (UDCA) treatment, clinical suspicion and previous colorectal-cancer were predictors of malignancy. Among 89 patients with a strong suspicion of malignancy prior to acceptance, 35 (39%) had confirmed malignancy. A clinical suspicion had been raised in 35/52 (67%) patients with malignancy. Malignancy was found in 31/223 patients who received a liver allograft. The 1-, 3- and 5-year patient survival rates following transplantation for patients with PSC and cholangiocarcinoma were 65, 35 and 35%, respectively.

CONCLUSIONS:

Hepatobiliary malignancy is suspected in 1/3 of the PSC patients and found in 1/5. Although cholangiocarcinoma is regarded as a contraindication to liver transplantation (LTX), PSC patients with cholangiocarcinoma had a 35% 5-year survival following transplantation.

• Authors: B Brandsaeter, Helena Isoniemi, Ulrika Broomé, Michael Olausson, Lars Bäckman, Bent Hansen, Erik Schrumpf, Antti Oksanen, Bo-Göran Ericzon, Krister Höckerstedt, Heikki Mäkisalo, Preben Kirkegaard, Styrbjörn Friman, Kristian Bjøro
• Journal: Journal of hepatology (J Hepatol) Vol. 40 Issue 5 Pg. 815-22 (May 2004) ISSN: 0168-8278 [Print] Netherlands
• PMID: 15094230 (Publication Type: Journal Article)

Topics

• Adult
• Biliary Tract Neoplasms (complications)
• Carcinoma, Hepatocellular (complications)
• Cholangiocarcinoma (complications)
• Cholangitis, Sclerosing (complications, mortality, surgery)
• Colorectal Neoplasms (complications)
• Contraindications
• Female
• Gallbladder Neoplasms (complications)
• Humans
• Liver Neoplasms (complications)
• Liver Transplantation
• Male
• Middle Aged
• Prognosis
• Survival Rate