Follow-up after liver transplantation for primary sclerosing cholangitis: effects on survival, quality of life, and colitis.

BACKGROUND

Except for primary biliary cirrhosis, primary sclerosing cholangitis (PSC) is now the commonest indication for liver transplantation in Sweden. There are several specific problems related to post-transplantation life in these patients.

METHODS

We analyzed a 10-year cohort of 47 patients transplanted at our center.

RESULTS

Incidental biliary carcinoma was diagnosed in 13%,, with a 2-year survival of only 17%, compared with 70% in the other patients. The 2-year survival has improved considerably (to 82%) in recent years. Quality of life was much or slightly improved in 80%. The colitis was much or slightly improved in 65%, with some deterioration in only 6%. No patient developed colonic carcinoma. Previous biliary tract surgery was identified as a risk factor for a worse 1-year mortality.

CONCLUSIONS

Liver transplantation for PSC is now associated with a high survival rate and an improvement in the quality of life and course of ulcerative colitis. Previous biliary tract surgery is a risk factor for non-survival.