Transplantation Trends in PBC

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Transplantation

Trends in Primary Biliary Cirrhosis

2007 Jarone Lee, Adam Belanger, T. Doucette, Carmen Stanca, Friedman and Bach

Department of  Medicine, Division of Liver

Diseases/Transplant Institute, Mount Sinai Medical Center,

New York, New York

Background

& Aims: Ursodeoxycholic

acid (UDCA) has shown efficacy in primary biliary cirrhosis (PBC), a chronic,

slowly progressive disease. We hypothesized that UDCA

use would reduce the need for liver transplantation in PBC. Our

study’s aim was to assess liver transplantation requirements in PBC over

a 12-year period. For comparison, we studied patients

with primary sclerosing cholangitis

(PSC) because it shares similar characteristics to PBC, but with a decreased

response to UDCA. Methods:

PBC and PSC transplant data of first-time liver recipients from the United

Network for Organ Sharing database were collected from 1995 to 2006. Results: The absolute

number of liver transplantations in the United

States increased an average of 249

transplants per year (P <

..001). The absolute number of transplants performed

for PBC decreased an average of 5.4 cases per year (P = .004). The absolute number of

transplantations for PSC showed no statistical change (P = .621). The

trends for the absolute number of individuals added to the transplant waitlist

showed a similar pattern: (1) an increase in total listings for transplants of

all diagnoses (β = 265; P =

..001); (2) a decrease in PBC (β = −12.1; P < .001); (3) and no change for PSC (β =

−5.434; P = .083). Conclusions: The liver

transplantation burden of PBC in the United

States decreased between 1995 and 2006. This is despite an increase in total liver transplants and

no change in transplant rates for PSC.

Whatever it Takes!

Son Ken (33) UC 91 - PSC 99 - Tx 6/21 & 6/30/07 @ Baylor in Dallas