| Theme | Prognosis of Liver Diseases | |
|---|---|---|
| Title | Prognosis of and Indications for Liver Transplantation in Primary Biliary Cirrhosis | |
| Publish Date | 1997/10 | |
| Author | Junko Hirohara | Third Department of Internal Medicine, Kansai Medical University |
| Author | Kyoichi Inoue | Third Department of Internal Medicine, Kansai Medical University |
| [ Summary ] | The median survival of Japanese patients with asymptomatic primary biliary cirrhosis (PBC) was 15.5 years on follow-up for 20 years by the Research Group for Intractable Liver Disease sponsored by the Ministry of Health and Welfare of Japan. Symptoms developed in 12% of asymptomatic patients. Most asymptomatic patients remained symptom-free for many years, and their mortality rate was not significantly different from that of the normal age-and sex matched population. The median survivals of symptomatic-PBC with pruritus and jaundice were 12 and 4.5 years, respectively. The survival of patients with jaundice in the 1990's was improved as compared to former patients. This fact suggests that the effects of treatment with ursodeoxycholic acid and endoscopic therapy for G-I bleeding may influence the natural course of PBC. Our suggestions for the decision and timing of liver transplantation in PBC are as follows : one should consider liver transplantation in a PBC patient when the estimated survival in the absence of transplantation is less than one year by mathematical models. One should consider liver transplantation in a PBC patient who has variceal bleeding not controlled by sclerotherapy. |
|