Liver transplantation for critically Ill patients with secondary sclerosing cholangitis: Outcome and complications. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Voigtländer, Torsten; Jaeckel, Elmar; Lehner, Frank; Manns, Michael P.; Lankisch, Tim O.
• Is Part Of: Liver transplantation. Volume 21:Issue 10(2015:Oct.)
• Page Start: 1295
• Page End: 1299
• Publication Date: 2015-10
• Subjects: Liver -- Transplantation -- Periodicals; Liver -- Diseases -- Periodicals; Liver Transplantation -- Periodicals; Foie -- Greffe -- Périodiques; 617.5560592
• DOI: 10.1002/lt.24192
• Languages: English
• ISSNs: 1527-6465

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>Secondary sclerosing cholangitis in critically ill patients (SSC‐CIP) is a destructive cholangiopathy with a poor prognosis. Liver transplantation (LT) is an established therapeutic option in end‐stage liver disease but is insufficiently evaluated in patients with SSC‐CIP. Our aim was the retrospective analysis of the outcome and complications of patients with SSC‐CIP undergoing LT between 2002 and 2012. Demographic characteristics, laboratory, transplantation, and follow‐up data were compared to sex‐ and age‐matched patients undergoing LT because of other reasons. Quality of life (QoL) before and after LT was assessed in a retrospective telephone interview. LT was performed in 21 patients with SSC‐CIP. The main causes for intensive care unit admission comprised cardiothoracic surgery interventions (10/21, 48%), polytrauma (6/21, 29%), and pneumonia (3/21, 14%). Median follow‐up period after LT was 82 months (interquartile range [IQR], 37‐129) for patients with SSC‐CIP and 83 months (IQR, 55‐104) for control patients. Biopsy‐proven rejection episodes in patients with SSC‐CIP (4/21, 19%) were similar compared to control patients (12/60, 20%; <italic>P</italic> = 0.93). Cytomegalovirus infections were equal in both groups (10/21, 48% versus 25/60, 42%; <italic>P</italic> = 0.64). The 1‐, 3‐, and 5‐year survival rates of patients with SSC‐CIP versus control patients were 100% versus 98%, 86% versus 92%, and 76% versus 87%, respectively (<italic>P</italic> > 0.05). The QoL improved significantly after LT in SSC‐CIP. In conclusion, LT is a valid option for patients with SSC‐CIP with excellent long‐term outcome and improvement of QoL. <italic>Liver Transpl 21:1295‐1299, 2015</italic>. © 2015 AASLD.</p> </abstract>