Relationships between sclerosing cholangitis, inflammatory bowel disease, and cancer in patients undergoing liver transplantation

doi:10.1016/S0039-6060(05)80026-1

Surgery

Volume 118, Issue 4, October 1995, Pages 615-620

https://doi.org/10.1016/S0039-6060(05)80026-1 Get rights and content

Background. Liver transplantation has emerged as the definitive treatment for primary sclerosing cholangitis (PSC). Its relationships to inflammatory bowel disease and cholangiocarcinoma were evaluated in this series.

Methods. Fifty-three liver transplantations were performed in 41 patients with PSC at the University of Wisconsin from 1986 through 1994. Fourteen of the patients underwent colectomies for inflammatory bowel disease, eight before transplantation and six after transplantation. Five patients had cholangiocarcinoma on the hepatectomy specimen, and another two had been diagnosed before transplantation.

Results. Patient survival for PSC without cholangiocarcinoma was 85% and 62% at 2 and 9 years, respectively. No patient with PSC and cholangiocarcinoma has survived 2 years, although two patients were free of disease 11 and 20 months after transplantation. Despite maintenance immunosuppression seven patients with liver transplants had reactivation of inflammatory bowel disease and colon carcinoma developed in three after liver transplantation.

Conclusions. Liver transplantation should be performed early in the course of PSC to avoid the lethal complications of cholangiocarcinoma. Careful colonoscopic follow-up is necessary in patients undergoing transplantation for PSC because immunosuppressive therapy does not necessarily cause inflammatory bowel disease to be quiescent, nor does it reduce the risk of colon carcinoma developing.

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^*: Presented at the Fifty-second Annual Meeting of the Central Surgical Association, Cleveland, Ohio, March 9–11, 1995.

View full text

Relationships between sclerosing cholangitis, inflammatory bowel disease, and cancer in patients undergoing liver transplantation*

Gastroenterology

Gastroenterology

Gastroenterology

Surgery

Primary sclerosing cholangitis: surgical options, prognostic variables and outcome

Br J Surg

Primary sclerosing cholangitis

N Engl J Med

Primary sclerosing cholangitis: natural history, prognostic factors and survival analysis

Hepatology

Does primary sclerosing cholangitis occurring in association with inflammatory bowel disease differ from that occurring in the absence of inflammatory bowel disease? a study of sixty-six subjects

Hepatology

Outcome of primary sclerosing cholangitis: analysis of long-term observation of 38 patients

Arch Intern Med