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J Hepatol. 2004 May;40(5):815-22.

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

Author information

1
Section of Hepatology and Gastroentrology, Department of Medicine, Rikshospitalet, 0027 Oslo, Norway. bjorn.brandsaeter@rikshospitalet.no

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.

PMID:
15094230
DOI:
10.1016/j.jhep.2004.01.002
[Indexed for MEDLINE]

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