Risk 4 Recurrence PSC After LDLT

[Guest guest]

Risk Factors for Recurrence of Primary Sclerosing Cholangitis After Living Donor Liver Transplantation: A Single Center Experience

We retrospectively reviewed our 10-year experience

with living donor liver transplantation (LDLT) in 30 consecutive patients with

end-stage primary sclerosing cholangitis

(PSC) to determine long-term patient and graft survival and risk factors for

recurrence of PSC. For strict diagnosis of recurrence, patients with hepatic

artery thrombosis (n = 2),

ABO blood type incompatible transplantation (n = 3),

and postoperative survival shorter than 1 year (n = 5) were excluded from the study, leaving 20

patients for analysis. Recurrence was diagnosed in 11

patients 26–71 months after transplantation. Multivariate analysis

showed that cytomegalovirus diseases within 3 months after transplantation

and related donors were independent risk factors for recurrence. When the

effects on recurrence were compared among

donor-recipient relationships, there were significant differences, especially

between nonrelated donors and parents. Multivariate

analysis showed that age was an independent risk factor for time to graft loss.

Cytomegalovirus prophylaxis and avoidance of related donors are important in

reducing PSC recurrence, although this is a preliminary report with limitations

due to the small number of patients. LDLT for young patients with PSC using

grafts from their parents might have to be avoided

where deceased donor liver transplantation is available.

http://www.springerlink.com/content/6g56414v70715m4u/

Barb in Texas - Together in the Fight - Whatever it

Takes!

Son Ken (34) UC 91 PSC 99, LTX 6/21 &

6/30 2007 @ Baylor/Dallas

[Guest guest]

You know, with all the talk about growing our own livers, that’s

what crossed my mind. I wonder if our own liver tissue would just turn around

and scar up again.

========

Do you read this as saying for children who require transplant they should

avoid getting live donor support from their bio parents (given we may have

transferred the auto-immune predisposition for PSC)?

[Guest guest]

You know, with all the talk about growing our own livers, that’s

what crossed my mind. I wonder if our own liver tissue would just turn around

and scar up again.

========

Do you read this as saying for children who require transplant they should

avoid getting live donor support from their bio parents (given we may have

transferred the auto-immune predisposition for PSC)?