Live donor liver transplantation for primary sclerosing cholangitis: is disease recurrence increased?

Abstract

These data suggest that patients with PSC undergoing live donor liver transplantation, especially with biologically related donors, may have a higher risk to develop recurrent disease compared with the deceased donor setting. However, this fact has to be interpreted with great caution, primarily due to the rather small number of patients. Further studies analyzing pooled data of all transplant centers performing live donor liver transplantations are needed to confirm these findings.

Randomised clinical trial: vancomycin or metronidazole in patients with primary sclerosing cholangitis ‐ a pilot study

“…1,2 Liver transplantation (LT) is the only existing treatment shown to prolong survival; however, PSC recurs in up to one-third of deceased donor LT and up to two-thirds of living-related donor LT patients. 3,4 The most widely studied pharmacological agent in the treatment of cholestatic liver diseases, ursodeoxycholic acid (UDCA), improves serum liver tests in PSC, but unlike in primary biliary cirrhosis, does not appear to delay disease progression. [5][6][7] Furthermore, a recent large randomised trial has found highdose UDCA to be associated with serious adverse effects (AEs) in patients with PSC.…”

Primary Sclerosing Cholangitis: Is Any Treatment Worthwhile?

“…Both living and deceased donors may be considered but it has been suggested that living donor grafts are associated with increased disease recurrence, particularly in biologically related donors [45][46][47].…”

S2k Leitlinie Autoimmune Lebererkrankungen

“…Während es bei AIH, PBC und PSC wenige internationale Studien zur Lebendspende gibt [672,673], wurden in Japan zwei retrospektive Studien zu Langzeitverläufen nach Leberlebendspende bei PSC durchgeführt [674,675]. Während sich bei Berücksichtigung aller Verwandtenspenden per se kein erhöhtes Risiko im Vergleich zu Nicht-Verwandtenspenden zeigte, konnte bei Spenden durch erstgradige Verwandte ein 3,12-fach erhöhtes Risiko für ein PSC-Rezidiv sowie ein 2,48-fach erhöhtes Risiko für einen Transplantatverlust beobachtet werden [675].…”