| Theme | Primary Sclerosing Cholangitis | |
|---|---|---|
| Title | Treatment of Primary Sclerosing Cholangitis : Liver Transplantation (Indication in Foreign Country) | |
| Publish Date | 1998/02 | |
| Author | Mutsuo Sasaki | Department of Surgery, Hirosaki University School of Medicine |
| [ Summary ] | Operative indications and the results of primary sclerosing cholangitis were reviewed with a presentation of one case at our department. The patient, is a 31-year-old female, underwent living related liver transplantation with a left lobe graft (500g, 42.3% of estimated ideal liver weight) on September 9, 1995. She is currently doing well 2 years and 2 months after transplantation with an immunosuppressive regimen including steroids and FK506. The Mayo model of the natural history, in which bilirubin, histological stage, age, and splenomegaly were employed to calculate risk scores, is often referred to in determining the timing of liver transplantation for primary sclerosing cholangitis. Since primary sclerosing cholangitis has been reported to be a premalignant condition leading to cholangiocarcinoma development, liver transplantation has been offered to patients even in the relatively early stage. Namely, patients with a risk score exceeding greater than 4 occasionally develop incident cholangiocarcinoma. Thus, the Mayo model contributes to timing of liver transplantation. The recurrence rate of primary sclerosing cholangitis has been reported to be 10 to 20% and histological investigation is important for making a definite diagnosis of recurrence. Patient survivals at 1, 2, and 3 years are 95%, 90% and 85%, respectively, and the good prognosis after transplantation suggests primary sclerosing cholangitis to be a good indication for liver transplantation. |
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