Cited by 179Liver Diseases and ImmunityOrgan Transplantation Techniques and OutcomesPediatric Hepatobiliary Diseases and Treatments

Long‐term survival and impact of ursodeoxycholic acid treatment for recurrent primary biliary cirrhosis after liver transplantation

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Charatcharoenwitthaya, Phunchai, Pimentel, Sylvania, Talwalkar, Jayant A., Enders, Felicity T., Lindor, Keith D., Krom, Ruud A.F., Wiesner, Russell H.·2007·Liver Transplantation

Abstract

The recurrence of primary biliary cirrhosis (PBC) in the hepatic allograft may impact patient and graft survival with long-term follow-up. The efficacy of ursodeoxycholic acid (UDCA) for treatment of recurrent PBC after liver transplantation (LT) remains less well known. The aims of this study were as follows: 1) to determine the significance of recurrent PBC on overall survival among PBC patients who underwent LT, and 2) to determine the efficacy of UDCA treatment after LT in patients with recurrent PBC. A retrospective cohort study was conducted of 154 PBC patients who underwent LT with at least 1 yr of follow-up after transplantation from 1985 through 2005. A total of 52 patients with recurrent PBC were identified. After adjusting for age and gender, recurrent PBC was not associated with death or liver retransplantation (hazard ratio, 0.97, 95% confidence interval, 0.41-2.31; P = 0.9). A total of 38 patients with recurrent PBC received UDCA at an average dose of 12 mg/kg/day for a mean duration of 55 months. Over a 36-month period, an estimated 52% of UDCA-treated patients experienced normalization of serum alkaline phosphatase and alanine aminotransferase compared to 22% of untreated patients. There was no significant difference in the rate of histological progression between subgroups. UDCA did not influence patient and graft survival. In conclusion, the development of recurrent PBC has little impact on long-term survival or need for retransplantation. While UDCA therapy is associated with biochemical improvement, its role in delaying histologic progression remains unknown. In this short period of treatment, UDCA was not associated with improved patient and graft survival compared to untreated patients.

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Research works printed but not linked: 3

  1. Abu-Elamgd K, Demetris J, Rakela J, Balan V, Vinayek R, Irish W, et al. Transplantation for primary biliary cirrho- sis: recurrence and outcome in 421 patients [Abstract]. Hepatology 1997;26:176A.
  2. CHARATCHAROENWITTHAYA ET AL. LIVER TRANSPLANTATION.DOI 10.1002/lt. Published on behalf of the American Association for the Study of Liver Diseases 15276473, 2007, 9, · DOI
  3. Starzl TE, Demetris AJ, Van Thiel D. Liver transplanta- tion. N Engl J Med. 1989;321:1014-1022.

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Authors
Charatcharoenwitthaya, P., Pimentel, S., Talwalkar, J. A., Enders, F. T., Lindor, K. D., Krom, R. A. F., & Wiesner, R. H.
Affiliations
Mayo Clinic (US)
Corresponding author
Talwalkar, Jayant A.
Venue
Liver Transplantation
Published
2007
Volume
13
Issue
9
Pages
1236-1245
ISSN
  • 1527-6465 (ISSN-L)
  • 1527-6473
OpenAlex
W2022135364
Cited by
179
References
45
Citations by year
2026: 2 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 8 · 2021: 9 · 2020: 19 · 2019: 3 · 2018: 13 · 2017: 12 · 2016: 7 · 2015: 14 · 2014: 10 · 2013: 11 · 2012: 13
FWCI
6.35
Type
journal article
Language
en
Open access
Locations
  • Liver Transplantation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Mahidol University
  • Faculty of Medicine Siriraj Hospital, Mahidol University
Topics
  • Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
  • Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
Keywords
primary biliary cirrhosis, ursodeoxycholic acid, patient survival, graft survival, liver retransplantation, biochemical markers, histological progression, long-term follow-up
MeSH terms
Adult, Aged, Cholagogues and Choleretics, Female, Humans, Liver Cirrhosis, Biliary, Male, Middle Aged, Probability, Recurrence, Retrospective Studies, Ursodeoxycholic Acid, Survival Analysis, Liver Transplantation, Survivors

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