Download PDF
Semin Liver Dis 2017; 37(04): 305-313
DOI: 10.1055/s-0037-1608655
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Timing, Management, and Outcomes of Liver Transplantation in Primary Sclerosing Cholangitis

Eric F. Martin
1   Department of Medicine, Miami Transplant Institute, Miami, Florida
2   Division of Hepatology, Miller School of Medicine, University of Miami, Miami, Florida
,
Cynthia Levy
2   Division of Hepatology, Miller School of Medicine, University of Miami, Miami, Florida
› Author Affiliations
Further Information

Publication History

Publication Date:
22 December 2017 (online)

    Permissions and Reprints

Abstract

Primary sclerosing cholangitis (PSC) is a chronic, immune-mediated cholestatic liver disease that often progresses to secondary biliary cirrhosis and end-stage liver disease. Short of liver transplantation (LT), there is no effective treatment for PSC. PSC accounts for approximately 5% of total adult LTs in the US and is currently the fifth most common indication for LT. Patient and graft survival for PSC is among the highest for all indications for LT. The main factors that impact outcomes after LT for PSC include biliary strictures, rejection, and recurrence of PSC. Recurrent PSC (rPSC) develops in 20% of LT recipients within 5 years of LT and is associated with negative patient and graft survival. LT is a viable option for recipients who develop rPSC and progress to graft failure.

Keywords

primary sclerosing cholangitis - liver transplantation - recurrence - outcomes
 

  • References

  • 1 Bambha K, Kim WR, Talwalkar J. , et al. Incidence, clinical spectrum, and outcomes of primary sclerosing cholangitis in a United States community. Gastroenterology 2003; 125 (05) 1364-1369
    CrossrefPubMedGoogle Scholar
  • 2 Burak K, Angulo P, Pasha TM, Egan K, Petz J, Lindor KD. Incidence and risk factors for cholangiocarcinoma in primary sclerosing cholangitis. Am J Gastroenterol 2004; 99 (03) 523-526
    CrossrefPubMedGoogle Scholar
  • 3 Claessen MM, Vleggaar FP, Tytgat KM, Siersema PD, van Buuren HR. High lifetime risk of cancer in primary sclerosing cholangitis. J Hepatol 2009; 50 (01) 158-164
    CrossrefPubMedGoogle Scholar
  • 4 Soetikno RM, Lin OS, Heidenreich PA, Young HS, Blackstone MO. Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis: a meta-analysis. Gastrointest Endosc 2002; 56 (01) 48-54
    CrossrefPubMedGoogle Scholar
  • 5 Zheng HH, Jiang XL. Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and inflammatory bowel disease: a meta-analysis of 16 observational studies. Eur J Gastroenterol Hepatol 2016; 28 (04) 383-390
    CrossrefPubMedGoogle Scholar
  • 6 Boonstra K, Weersma RK, van Erpecum KJ. , et al; EpiPSCPBC Study Group. Population-based epidemiology, malignancy risk, and outcome of primary sclerosing cholangitis. Hepatology 2013; 58 (06) 2045-2055
    CrossrefPubMedGoogle Scholar
  • 7 Goldberg DS, Camp A, Martinez-Camacho A, Forman L, Fortune B, Reddy KR. Risk of waitlist mortality in patients with primary sclerosing cholangitis and bacterial cholangitis. Liver Transpl 2013; 19 (03) 250-258
    CrossrefPubMedGoogle Scholar
  • 8 Porayko MK, Wiesner RH, LaRusso NF. , et al. Patients with asymptomatic primary sclerosing cholangitis frequently have progressive disease. Gastroenterology 1990; 98 (06) 1594-1602
    CrossrefPubMedGoogle Scholar
  • 9 Ruiz A, Lemoinne S, Carrat F, Corpechot C, Chazouillères O, Arrivé L. Radiologic course of primary sclerosing cholangitis: assessment by three-dimensional magnetic resonance cholangiography and predictive features of progression. Hepatology 2014; 59 (01) 242-250
    CrossrefPubMedGoogle Scholar
  • 10 Toy E, Balasubramanian S, Selmi C, Li CS, Bowlus CL. The prevalence, incidence and natural history of primary sclerosing cholangitis in an ethnically diverse population. BMC Gastroenterol 2011; 11: 83
    CrossrefPubMedGoogle Scholar
  • 11 de Valle MB, Björnsson E, Lindkvist B. Mortality and cancer risk related to primary sclerosing cholangitis in a Swedish population-based cohort. Liver Int 2012; 32 (03) 441-448
    PubMedGoogle Scholar
  • 12 Fevery J, Henckaerts L, Van Oirbeek R. , et al. Malignancies and mortality in 200 patients with primary sclerosering cholangitis: a long-term single-centre study. Liver Int 2012; 32 (02) 214-222
    CrossrefPubMedGoogle Scholar
  • 13 Kingham JG, Kochar N, Gravenor MB. Incidence, clinical patterns, and outcomes of primary sclerosing cholangitis in South Wales, United Kingdom. Gastroenterology 2004; 126 (07) 1929-1930
    CrossrefPubMedGoogle Scholar
  • 14 Angulo P, Maor-Kendler Y, Lindor KD. Small-duct primary sclerosing cholangitis: a long-term follow-up study. Hepatology 2002; 35 (06) 1494-1500
    CrossrefPubMedGoogle Scholar
  • 15 Björnsson E, Olsson R, Bergquist A. , et al. The natural history of small-duct primary sclerosing cholangitis. Gastroenterology 2008; 134 (04) 975-980
    CrossrefPubMedGoogle Scholar
  • 16 Tischendorf JJ, Hecker H, Krüger M, Manns MP, Meier PN. Characterization, outcome, and prognosis in 273 patients with primary sclerosing cholangitis: a single center study. Am J Gastroenterol 2007; 102 (01) 107-114
    CrossrefPubMedGoogle Scholar
  • 17 Rosen CB, Heimbach JK, Gores GJ. Surgery for cholangiocarcinoma: the role of liver transplantation. HPB 2008; 10 (03) 186-189
    CrossrefPubMedGoogle Scholar
  • 18 Darwish Murad S, Kim WR, Harnois DM. , et al. Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers. Gastroenterology 2012; 143 (01) 88-98.e3 ; quiz e14
    CrossrefPubMedGoogle Scholar
  • 19 Andersen IM, Fosby B, Boberg KM. , et al. Indications and outcomes in liver transplantation in patients with primary sclerosing cholangitis in Norway. Transplant Direct 2015; 1 (09) e39
    PubMedGoogle Scholar
  • 20 Boberg KM, Jebsen P, Clausen OP, Foss A, Aabakken L, Schrumpf E. Diagnostic benefit of biliary brush cytology in cholangiocarcinoma in primary sclerosing cholangitis. J Hepatol 2006; 45 (04) 568-574
    CrossrefPubMedGoogle Scholar
  • 21 (UNOS) UNOS. Available at: https://www.unos.org . Accessed July 17, 2017
    PubMed
  • 22 Fosby B, Melum E, Bjøro K. , et al. Liver transplantation in the Nordic countries - An intention to treat and post-transplant analysis from The Nordic Liver Transplant Registry 1982-2013. Scand J Gastroenterol 2015; 50 (06) 797-808
    CrossrefPubMedGoogle Scholar
  • 23 Futagawa Y, Terasaki PI. An analysis of the OPTN/UNOS Liver Transplant Registry. Clin Transpl 2004; 315-329
    PubMedGoogle Scholar
  • 24 Singal AK, Guturu P, Hmoud B, Kuo YF, Salameh H, Wiesner RH. Evolving frequency and outcomes of liver transplantation based on etiology of liver disease. Transplantation 2013; 95 (05) 755-760
    CrossrefPubMedGoogle Scholar
  • 25 Adam R, Karam V, Delvart V. , et al; All contributing centers ( www.eltr.org ); European Liver and Intestine Transplant Association (ELITA). Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol 2012; 57 (03) 675-688
    CrossrefPubMedGoogle Scholar
  • 26 Alabraba E, Nightingale P, Gunson B. , et al. A re-evaluation of the risk factors for the recurrence of primary sclerosing cholangitis in liver allografts. Liver Transpl 2009; 15 (03) 330-340
    CrossrefPubMedGoogle Scholar
  • 27 Graziadei IW, Wiesner RH, Marotta PJ. , et al. Long-term results of patients undergoing liver transplantation for primary sclerosing cholangitis. Hepatology 1999; 30 (05) 1121-1127
    CrossrefPubMedGoogle Scholar
  • 28 Kashyap R, Safadjou S, Chen R. , et al. Living donor and deceased donor liver transplantation for autoimmune and cholestatic liver diseases–an analysis of the UNOS database. J Gastrointest Surg 2010; 14 (09) 1362-1369
    CrossrefPubMedGoogle Scholar
  • 29 Patt CH, Thuluvath TP. Liver transplantation for primary sclerosing cholangitis: screening for biliary malignancy and the role of preemptive transplantation. Curr Opin Organ Transplant 2002; 7: 129-136
    CrossrefPubMedGoogle Scholar
  • 30 Goldberg D, Bittermann T, Makar G. Lack of standardization in exception points for patients with primary sclerosing cholangitis and bacterial cholangitis. Am J Transplant 2012; 12 (06) 1603-1609
    CrossrefPubMedGoogle Scholar
  • 31 Goldberg D, French B, Thomasson A, Reddy KR, Halpern SD. Waitlist survival of patients with primary sclerosing cholangitis in the model for end-stage liver disease era. Liver Transpl 2011; 17 (11) 1355-1363
    CrossrefPubMedGoogle Scholar
  • 32 Goldberg DS, French B, Thomasson A, Reddy KR, Halpern SD. Current trends in living donor liver transplantation for primary sclerosing cholangitis. Transplantation 2011; 91 (10) 1148-1152
    CrossrefPubMedGoogle Scholar
  • 33 Sundaram V, Choi G, Jeon CY. , et al. Donation after cardiac death liver transplantation in primary sclerosing cholangitis: proceed with caution. Transplantation 2015; 99 (05) 973-978
    CrossrefPubMedGoogle Scholar
  • 34 Graziadei IW, Wiesner RH, Batts KP. , et al. Recurrence of primary sclerosing cholangitis following liver transplantation. Hepatology 1999; 29 (04) 1050-1056
    CrossrefPubMedGoogle Scholar
  • 35 Sheng R, Campbell WL, Zajko AB, Baron RL. Cholangiographic features of biliary strictures after liver transplantation for primary sclerosing cholangitis: evidence of recurrent disease. Am J Roentgenol 1996; 166 (05) 1109-1113
    CrossrefPubMedGoogle Scholar
  • 36 Fosby B, Karlsen TH, Melum E. Recurrence and rejection in liver transplantation for primary sclerosing cholangitis. World J Gastroenterol 2012; 18 (01) 1-15
    CrossrefPubMedGoogle Scholar
  • 37 Hildebrand T, Pannicke N, Dechene A. , et al; German PSC Study Group. Biliary strictures and recurrence after liver transplantation for primary sclerosing cholangitis: A retrospective multicenter analysis. Liver Transpl 2016; 22 (01) 42-52
    CrossrefPubMedGoogle Scholar
  • 38 Alexander J, Lord JD, Yeh MM, Cuevas C, Bakthavatsalam R, Kowdley KV. Risk factors for recurrence of primary sclerosing cholangitis after liver transplantation. Liver Transpl 2008; 14 (02) 245-251
    CrossrefPubMedGoogle Scholar
  • 39 Brandsaeter B, Schrumpf E, Bentdal O. , et al. Recurrent primary sclerosing cholangitis after liver transplantation: a magnetic resonance cholangiography study with analyses of predictive factors. Liver Transpl 2005; 11 (11) 1361-1369
    CrossrefPubMedGoogle Scholar
  • 40 Campsen J, Zimmerman MA, Trotter JF. , et al. Clinically recurrent primary sclerosing cholangitis following liver transplantation: a time course. Liver Transpl 2008; 14 (02) 181-185
    CrossrefPubMedGoogle Scholar
  • 41 Egawa H, Ueda Y, Ichida T. , et al. Risk factors for recurrence of primary sclerosing cholangitis after living donor liver transplantation in Japanese registry. Am J Transplant 2011; 11 (03) 518-527
    CrossrefPubMedGoogle Scholar
  • 42 Jeyarajah DR, Netto GJ, Lee SP. , et al. Recurrent primary sclerosing cholangitis after orthotopic liver transplantation: is chronic rejection part of the disease process?. Transplantation 1998; 66 (10) 1300-1306
    CrossrefPubMedGoogle Scholar
  • 43 Khettry U, Keaveny A, Goldar-Najafi A. , et al. Liver transplantation for primary sclerosing cholangitis: a long-term clinicopathologic study. Hum Pathol 2003; 34 (11) 1127-1136
    CrossrefPubMedGoogle Scholar
  • 44 Kugelmas M, Spiegelman P, Osgood MJ. , et al. Different immunosuppressive regimens and recurrence of primary sclerosing cholangitis after liver transplantation. Liver Transpl 2003; 9 (07) 727-732
    CrossrefPubMedGoogle Scholar
  • 45 Ravikumar R, Tsochatzis E, Jose S. , et al. Risk factors for recurrent primary sclerosing cholangitis after liver transplantation. J Hepatol 2015; 63 (05) 1139-1146
    CrossrefPubMedGoogle Scholar
  • 46 Vera A, Moledina S, Gunson B. , et al. Risk factors for recurrence of primary sclerosing cholangitis of liver allograft. Lancet 2002; 360 (9349): 1943-1944
    CrossrefPubMedGoogle Scholar
  • 47 Gordon FD, Goldberg DS, Goodrich NP. , et al. Recurrent primary sclerosing cholangitis in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study: Comparison of risk factors between living and deceased donor recipients. Liver Transpl 2016; 22 (09) 1214-1222
    CrossrefPubMedGoogle Scholar
  • 48 Carbone M, Neuberger J. Liver transplantation in PBC and PSC: indications and disease recurrence. Clin Res Hepatol Gastroenterol 2011; 35 (6-7): 446-454
    CrossrefPubMedGoogle Scholar
  • 49 Graziadei IW. Recurrence of nonviral liver diseases after liver transplantation. Clin Liver Dis 2014; 18 (03) 675-685
    CrossrefPubMedGoogle Scholar
  • 50 Pardi DS, Loftus Jr EV, Kremers WK, Keach J, Lindor KD. Ursodeoxycholic acid as a chemopreventive agent in patients with ulcerative colitis and primary sclerosing cholangitis. Gastroenterology 2003; 124 (04) 889-893
    CrossrefPubMedGoogle Scholar
  • 51 Sharma S, Gurakar A, Jabbour N. Biliary strictures following liver transplantation: past, present and preventive strategies. Liver Transpl 2008; 14 (06) 759-769
    CrossrefPubMedGoogle Scholar
  • 52 Welsh FK, Wigmore SJ. Roux-en-Y choledochojejunostomy is the method of choice for biliary reconstruction in liver transplantation for primary sclerosing cholangitis. Transplantation 2004; 77 (04) 602-604
    CrossrefPubMedGoogle Scholar
  • 53 Koornstra JJ. Double balloon enteroscopy for endoscopic retrograde cholangiopancreaticography after Roux-en-Y reconstruction: case series and review of the literature. Neth J Med 2008; 66 (07) 275-279
    PubMedGoogle Scholar
  • 54 Saleem A, Baron TH, Gostout CJ. , et al. Endoscopic retrograde cholangiopancreatography using a single-balloon enteroscope in patients with altered Roux-en-Y anatomy. Endoscopy 2010; 42 (08) 656-660
    Article in Thieme ConnectPubMedGoogle Scholar
  • 55 Damrah O, Sharma D, Burroughs A. , et al. Duct-to-duct biliary reconstruction in orthotopic liver transplantation for primary sclerosing cholangitis: a viable and safe alternative. Transpl Int 2012; 25 (01) 64-68
    CrossrefPubMedGoogle Scholar
  • 56 Pandanaboyana S, Bell R, Bartlett AJ, McCall J, Hidalgo E. Meta-analysis of duct-to-duct versus Roux-en-Y biliary reconstruction following liver transplantation for primary sclerosing cholangitis. Transpl Int 2015; 28 (04) 485-491
    CrossrefPubMedGoogle Scholar
  • 57 Sutton ME, Bense RD, Lisman T, van der Jagt EJ, van den Berg AP, Porte RJ. Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy. Liver Transpl 2014; 20 (04) 457-463
    CrossrefPubMedGoogle Scholar
  • 58 Chuang JH, Lee SY, Chen WJ, Hsieh CS, Chang NK, Lo SK. Changes in bacterial concentration in the liver correlate with that in the hepaticojejunostomy after bile duct reconstruction: implication in the pathogenesis of postoperative cholangitis. World J Surg 2001; 25 (12) 1512-1518
    CrossrefPubMedGoogle Scholar
  • 59 Schmitz V, Neumann UP, Puhl G, Tran ZV, Neuhaus P, Langrehr JM. Surgical complications and long-term outcome of different biliary reconstructions in liver transplantation for primary sclerosing cholangitis-choledochoduodenostomy versus choledochojejunostomy. Am J Transplant 2006; 6 (02) 379-385
    CrossrefPubMedGoogle Scholar
  • 60 Shaked A, Ghobrial RM, Merion RM. , et al; A2ALL Study Group. Incidence and severity of acute cellular rejection in recipients undergoing adult living donor or deceased donor liver transplantation. Am J Transplant 2009; 9 (02) 301-308
    CrossrefPubMedGoogle Scholar
  • 61 Milkiewicz P, Gunson B, Saksena S, Hathaway M, Hubscher SG, Elias E. Increased incidence of chronic rejection in adult patients transplanted for autoimmune hepatitis: assessment of risk factors. Transplantation 2000; 70 (03) 477-480
    CrossrefPubMedGoogle Scholar
  • 62 Uemura T, Ikegami T, Sanchez EQ. , et al. Late acute rejection after liver transplantation impacts patient survival. Clin Transplant 2008; 22 (03) 316-323
    CrossrefPubMedGoogle Scholar
  • 63 Goss JA, Shackleton CR, Farmer DG. , et al. Orthotopic liver transplantation for primary sclerosing cholangitis. A 12-year single center experience. Ann Surg 1997; 225 (05) 472-481 , discussion; 481–483
    CrossrefPubMedGoogle Scholar
  • 64 Rowe IA, Webb K, Gunson BK, Mehta N, Haque S, Neuberger J. The impact of disease recurrence on graft survival following liver transplantation: a single centre experience. Transpl Int 2008; 21 (05) 459-465
    CrossrefPubMedGoogle Scholar
  • 65 Maheshwari A, Yoo HY, Thuluvath PJ. Long-term outcome of liver transplantation in patients with PSC: a comparative analysis with PBC. Am J Gastroenterol 2004; 99 (03) 538-542
    CrossrefPubMedGoogle Scholar
  • 66 Kim WR, Wiesner RH, Poterucha JJ. , et al. Hepatic retransplantation in cholestatic liver disease: impact of the interval to retransplantation on survival and resource utilization. Hepatology 1999; 30 (02) 395-400
    CrossrefPubMedGoogle Scholar
  • 67 Rana A, Petrowsky H, Kaplan B. , et al. Early liver retransplantation in adults. Transpl Int 2014; 27 (02) 141-151
    CrossrefPubMedGoogle Scholar
  • 68 Yoo PS, Umman V, Rodriguez-Davalos MI, Emre SH. Retransplantation of the liver: review of current literature for decision making and technical considerations. Transplant Proc 2013; 45 (03) 854-859
    CrossrefPubMedGoogle Scholar
  • 69 Henson JB, Patel YA, King LY, Zheng J, Chow SC, Muir AJ. Outcomes of liver retransplantation in patients with primary sclerosing cholangitis. Liver Transpl 2017; 23 (06) 769-780
    CrossrefPubMedGoogle Scholar
  • 70 Boonstra K, Beuers U, Ponsioen CY. Epidemiology of primary sclerosing cholangitis and primary biliary cirrhosis: a systematic review. J Hepatol 2012; 56 (05) 1181-1188
    CrossrefPubMedGoogle Scholar
  • 71 Lunder AK, Hov JR, Borthne A. , et al. Prevalence of sclerosing cholangitis detected by magnetic resonance cholangiography in patients with long-term inflammatory bowel disease. Gastroenterology 2016; 151 (04) 660-669.e4
    CrossrefPubMedGoogle Scholar
  • 72 Singh S, Loftus Jr EV, Talwalkar JA. Inflammatory bowel disease after liver transplantation for primary sclerosing cholangitis. Am J Gastroenterol 2013; 108 (09) 1417-1425
    CrossrefPubMedGoogle Scholar
  • 73 Yarur AJ, Czul F, Levy C. Hepatobiliary manifestations of inflammatory bowel disease. Inflamm Bowel Dis 2014; 20 (09) 1655-1667
    CrossrefPubMedGoogle Scholar
  • 74 Dvorchik I, Subotin M, Demetris AJ. , et al. Effect of liver transplantation on inflammatory bowel disease in patients with primary sclerosing cholangitis. Hepatology 2002; 35 (02) 380-384
    CrossrefPubMedGoogle Scholar
  • 75 Jørgensen KK, Grzyb K, Lundin KE. , et al. Inflammatory bowel disease in patients with primary sclerosing cholangitis: clinical characterization in liver transplanted and nontransplanted patients. Inflamm Bowel Dis 2012; 18 (03) 536-545
    CrossrefPubMedGoogle Scholar
  • 76 Verdonk RC, Dijkstra G, Haagsma EB. , et al. Inflammatory bowel disease after liver transplantation: risk factors for recurrence and de novo disease. Am J Transplant 2006; 6 (06) 1422-1429
    CrossrefPubMedGoogle Scholar
  • 77 Befeler AS, Lissoos TW, Schiano TD. , et al. Clinical course and management of inflammatory bowel disease after liver transplantation. Transplantation 1998; 65 (03) 393-396
    CrossrefPubMedGoogle Scholar
  • 78 Joshi D, Bjarnason I, Belgaumkar A. , et al. The impact of inflammatory bowel disease post-liver transplantation for primary sclerosing cholangitis. Liver Int 2013; 33 (01) 53-61
    CrossrefPubMedGoogle Scholar
  • 79 Haagsma EB, Van Den Berg AP, Kleibeuker JH, Slooff MJ, Dijkstra G. Inflammatory bowel disease after liver transplantation: the effect of different immunosuppressive regimens. Aliment Pharmacol Ther 2003; 18 (01) 33-44
    CrossrefPubMedGoogle Scholar
  • 80 Schreuder TC, Hübscher SG, Neuberger J. Autoimmune liver diseases and recurrence after orthotopic liver transplantation: what have we learned so far?. Transpl Int 2009; 22 (02) 144-152
    CrossrefPubMedGoogle Scholar
  • 81 Cholongitas E, Papatheodoridis GV, Zappoli P. , et al. Combined HLA-DR and -DQ disparity is associated with a stable course of ulcerative colitis after liver transplantation for primary sclerosing cholangitis. Liver Transpl 2007; 13 (04) 552-557
    CrossrefPubMedGoogle Scholar
  • 82 Jørgensen KK, Lindström L, Cvancarova M. , et al. Immunosuppression after liver transplantation for primary sclerosing cholangitis influences activity of inflammatory bowel disease. Clin Gastroenterol Hepatol 2013; 11 (05) 517-523
    CrossrefPubMedGoogle Scholar
  • 83 Mohabbat AB, Sandborn WJ, Loftus Jr EV, Wiesner RH, Bruining DH. Anti-tumour necrosis factor treatment of inflammatory bowel disease in liver transplant recipients. Aliment Pharmacol Ther 2012; 36 (06) 569-574
    CrossrefPubMedGoogle Scholar
  • 84 Colombel JF, Sands BE, Rutgeerts P. , et al. The safety of vedolizumab for ulcerative colitis and Crohn's disease. Gut 2017; 66 (05) 839-851
    CrossrefPubMedGoogle Scholar
  • 85 Feagan BG, Rutgeerts P, Sands BE. , et al; GEMINI 1 Study Group. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2013; 369 (08) 699-710
    CrossrefPubMedGoogle Scholar
  • 86 Hartery K, O'Reilly S, Houlihan D. , et al. Letter: vedolizumab for the management of inflammatory bowel disease in patients after liver transplantation for primary sclerosing cholangitis. Aliment Pharmacol Ther 2017; 45 (02) 376-378
    CrossrefPubMedGoogle Scholar
  • 87 Lim TY, Pavlidis P, Gulati S. , et al. Vedolizumab in inflammatory bowel disease associated with autoimmune liver disease pre- and postliver transplantation: a case series. Inflamm Bowel Dis 2016; 22 (10) E39-E40
    CrossrefPubMedGoogle Scholar
  • 88 Meszaros M, Pageaux GP, Altwegg R. Management of ulcerative colitis using vedolizumab after liver transplantation for primary sclerosing cholangitis. J Crohn's Colitis 2016; 10 (02) 236
    PubMedGoogle Scholar
  • 89 Wright AP, Fontana RJ, Stidham RW. Vedolizumab is safe and effective in moderate-to-severe inflammatory bowel disease following liver transplantation. Liver Transpl 2017; 23 (07) 968-971
    CrossrefPubMedGoogle Scholar
  • 90 Loftus Jr EV, Aguilar HI, Sandborn WJ. , et al. Risk of colorectal neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis following orthotopic liver transplantation. Hepatology 1998; 27 (03) 685-690
    CrossrefPubMedGoogle Scholar
  • 91 Vera A, Gunson BK, Ussatoff V. , et al. Colorectal cancer in patients with inflammatory bowel disease after liver transplantation for primary sclerosing cholangitis. Transplantation 2003; 75 (12) 1983-1988
    CrossrefPubMedGoogle Scholar
  • 92 Lucey MR, Terrault N, Ojo L. , et al. Long-term management of the successful adult liver transplant: 2012 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Liver Transpl 2013; 19 (01) 3-26
    CrossrefPubMedGoogle Scholar
  • 93 Mouchli MA, Singh S, Loftus Jr EV. , et al. Risk factors and outcomes of de novo cancers (excluding nonmelanoma skin cancer) after liver transplantation for primary sclerosing cholangitis. Transplantation 2017; 101 (08) 1859-1866
    CrossrefPubMedGoogle Scholar
  • 94 Aberg F, Pukkala E, Höckerstedt K, Sankila R, Isoniemi H. Risk of malignant neoplasms after liver transplantation: a population-based study. Liver Transpl 2008; 14 (10) 1428-1436
    CrossrefPubMedGoogle Scholar
  • 95 Schrem H, Kurok M, Kaltenborn A. , et al. Incidence and long-term risk of de novo malignancies after liver transplantation with implications for prevention and detection. Liver Transpl 2013; 19 (11) 1252-1261
    CrossrefPubMedGoogle Scholar
  • 96 Heneghan MA, Tuttle-Newhall JE, Suhocki PV. , et al. De-novo cholangiocarcinoma in the setting of recurrent primary sclerosing cholangitis following liver transplant. Am J Transplant 2003; 3 (05) 634-638
    CrossrefPubMedGoogle Scholar
  • 97 Khorsandi SESS, Salvans S, Zen Y, Agarwal K, Jassem W, Heaton N. Cholangiocarcinoma complicating recurrent primary sclerosing cholangitis after liver transplantation. Transpl Int 2011; 24 (10) e93-e96
    CrossrefPubMedGoogle Scholar
  • 98 Coussens LM, Werb Z. Inflammation and cancer. Nature 2002; 420 (6917): 860-867
    CrossrefPubMedGoogle Scholar
  • 99 Charatcharoenwitthaya P, Enders FB, Halling KC, Lindor KD. Utility of serum tumor markers, imaging, and biliary cytology for detecting cholangiocarcinoma in primary sclerosing cholangitis. Hepatology 2008; 48 (04) 1106-1117
    CrossrefPubMedGoogle Scholar
  • 100 Razumilava N, Gores GJ, Lindor KD. Cancer surveillance in patients with primary sclerosing cholangitis. Hepatology 2011; 54 (05) 1842-1852
    CrossrefPubMedGoogle Scholar
  • 101 Guichelaar MM, Kendall R, Malinchoc M, Hay JE. Bone mineral density before and after OLT: long-term follow-up and predictive factors. Liver Transpl 2006; 12 (09) 1390-1402
    CrossrefPubMedGoogle Scholar