Liver transplantation for primary biliary cirrhosis in a hepatitis endemic region: a single-center Asian experience

• Published in: Clinical transplantation 2011-01, Vol.25 (1), p.47-53
• Main Authors: Sun, Cheuk-Kwan, Chen, Chao-Long, Concejero, Allan M., Wang, Chih-Chi, Wang, Shih-Ho, Liu, Yueh-Wei, Yang, Chin-Hsiang, Yong, Chee-Chien
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; anti-HBc(+) grafts; Biological and medical sciences; China; Cyclosporine - therapeutic use; Cyclosporins; Donors; Endemic Diseases - prevention & control; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Gastroenterology. Liver. Pancreas. Abdomen; Graft Rejection - prevention & control; Hepatitis B - prevention & control; Hepatitis B - virology; Hepatitis B virus; Hepatitis B virus - pathogenicity; Hepatitis C; Humans; Immunosuppression; Immunosuppressive Agents - therapeutic use; Liver Cirrhosis, Biliary - surgery; Liver Cirrhosis, Biliary - virology; Liver diseases; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; living donor liver transplantation; Living Donors; Male; Medical sciences; Middle Aged; Other diseases. Semiology; primary biliary cirrhosis; Prophylaxis; Recurrent infection; Sun; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival; Survival Rate; Tacrolimus; Tacrolimus - therapeutic use; Tissue, organ and graft immunology; Treatment Outcome; viral hepatitis
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2010.01288.x

Sun C‐K, Chen C‐L, Concejero AM, Wang C‐C, Wang S‐H, Liu Y‐W, Yang C‐H, Yong C‐C. Liver transplantation for primary biliary cirrhosis in a hepatitis endemic region: a single‐center Asian experience.
Clin Transplant 2011: 25: 47–53. © 2010 John Wiley & Sons A/S. :  From March 1984 to November 2008, we performed 539 primary liver transplantations (LTs). Nineteen (19, 3.5%) were transplanted for end‐stage liver disease secondary to primary biliary cirrhosis (PBC). There were 17 (89%) female and 2 (11%) male recipients. The overall mean age was 50.3 ± 6.3 yr. The mean model for end‐stage liver disease, and Child–Turcotte–Pugh scores were 20.7 ± 2.1, and 11.0 ± 0.5, respectively. There were 2 (11%) United Network for Organ Sharing status 3, 16 (84%) 2B, and 1 (5%) 2A patients. Fourteen patients (14, 73.7%) underwent living donor LT, and five patients (26.3%) received deceased donor LT. The primary immunosuppression consisted of cyclosporine (n = 5) and tacrolimus (n = 14). Liver function returned to normal one month after transplantation. The overall mean follow‐up was 5.8 ± 0.8 yr (range, four months to 15.7 yr). The overall one‐, three‐, and five‐yr survival rates were 94.7%, 89.2%, and 89.2%, respectively. Without hepatitis B virus (HBV) prophylaxis, one patient acquired de novo HBV infection after receiving a graft from an anti‐HBc(+) donor. Another patient developed recurrent hepatitis C infection and expired 25 months after transplantation. Our results showed that HBV prophylaxis was effective not only against de novo infection, but it also worked on pre‐transplant HBV carrier with PBC and helped in virus clearance.