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Digestive Diseases and Sciences

, Volume 54, Issue 6, pp 1347–1354 | Cite as

Risk Factors for Recurrence of Primary Sclerosing Cholangitis After Living Donor Liver Transplantation: A Single Center Experience

  • Hiroto EgawaEmail author
  • Kaoru Taira
  • Satoshi Teramukai
  • Hironori Haga
  • Yoshihide Ueda
  • Atsushi Yonezawa
  • Satohiro Masuda
  • Hiroaki Tsuji
  • Eishi Ashihara
  • Yasutsugu Takada
  • Shinji Uemoto
Original Article

Abstract

We retrospectively reviewed our 10-year experience with living donor liver transplantation (LDLT) in 30 consecutive patients with end-stage primary sclerosing cholangitis (PSC) to determine long-term patient and graft survival and risk factors for recurrence of PSC. For strict diagnosis of recurrence, patients with hepatic artery thrombosis (n = 2), ABO blood type incompatible transplantation (n = 3), and postoperative survival shorter than 1 year (n = 5) were excluded from the study, leaving 20 patients for analysis. Recurrence was diagnosed in 11 patients 26–71 months after transplantation. Multivariate analysis showed that cytomegalovirus diseases within 3 months after transplantation and related donors were independent risk factors for recurrence. When the effects on recurrence were compared among donor-recipient relationships, there were significant differences, especially between nonrelated donors and parents. Multivariate analysis showed that age was an independent risk factor for time to graft loss. Cytomegalovirus prophylaxis and avoidance of related donors are important in reducing PSC recurrence, although this is a preliminary report with limitations due to the small number of patients. LDLT for young patients with PSC using grafts from their parents might have to be avoided where deceased donor liver transplantation is available.

Keywords

Primary sclerosing cholangitis Living donor liver transplantation Cytomegalovirus Recurrence Risk factor 

Abbreviations

PSC

Primary sclerosing cholangitis

LDLT

Living donor liver transplantation

CMV

Cytomegalovirus

ALP

Alkaline phosphatase

γ-GTP

Gamma-glutamyl transferase

MELD

Model for end-stage liver disease

HLA

Human leukocyte antigen

HR

Hazard ratio

CI

Confidence interval

Notes

Acknowledgments

This work was funded by a Health Science Research Grant on a Specific Disease (Study of Intractable Liver and Biliary Diseases), The Ministry of Health, Labor and Welfare of Japan, 2005 to 2007.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Hiroto Egawa
    • 1
    Email author
  • Kaoru Taira
    • 2
  • Satoshi Teramukai
    • 3
  • Hironori Haga
    • 1
    • 4
  • Yoshihide Ueda
    • 1
    • 5
  • Atsushi Yonezawa
    • 6
  • Satohiro Masuda
    • 6
  • Hiroaki Tsuji
    • 7
  • Eishi Ashihara
    • 7
  • Yasutsugu Takada
    • 2
  • Shinji Uemoto
    • 1
    • 2
  1. 1.Organ Transplant UnitKyoto University HospitalKyotoJapan
  2. 2.Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
  3. 3.Division of Clinical Trial Design and Management, Translational Research CenterKyoto University HospitalKyotoJapan
  4. 4.Faculty of Medicine, Department of Diagnostic PathologyKyoto UniversityKyotoJapan
  5. 5.Faculty of Medicine, Department of GastroenterologyKyoto UniversityKyotoJapan
  6. 6.Faculty of Medicine, Department of PharmacyKyoto UniversityKyotoJapan
  7. 7.Department of Blood Transfusion and ImmunologyKyoto University HospitalKyotoJapan

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