Recurrence of primary biliary cirrhosis after orthotopic liver transplantation.
OBJECTIVE
The incidence of graft failure due to recurrence of primary biliary cirrhosis after liver transplantation and the clinical value of histological and serological parameters indicating a recurrence are still discussed controversially in the literature.


METHODS
In a retrospective study 18 patients who had received orthotopic liver grafts for primary biliary cirrhosis were investigated for recurrence of disease. Histological findings, the appearance of primary biliary cirrhosis associated autoimmune diseases, the course of antimitochondrial antibodies, serological parameters of liver function and HLA status were evaluated.


RESULTS
During a median follow-up period of 114 months, 6 of 18 patients developed a recurrence of primary biliary cirrhosis as indicated by liver biopsies, one patient developed clinical graft failure together with histological recurrence. Twelve patients developed autoimmune diseases. Antimitochondrial antibodies were present in all patients within a period of 12 months after transplantation. Serological parameters were elevated in 16 of 18 patients. Histological findings, serological parameters and associated diseases did not correlate with each other and with clinical symptoms of primary biliary cirrhosis recurrence.


CONCLUSIONS
Graft failure due to recurrent disease can occur, but, despite a follow-up period of nearly 10 years, it is not possible to define predictive factors on the basis of histology or serology.
Kurdow
Roland
R
Clinic for General and Thoracic Surgery, University Clinic, Christian Albrechts University, Arnold-Heller Str. 7, 24105 Kiel, Germany. rkurdow@surgery.uni-kiel.de
Marks
Hans-Guenther
HG
Kraemer-Hansen
Heike
H
Lüttges
Jutta
J
Kremer
Bernd
B
Henne-Bruns
Doris
D
D000906:Antibodies / Q000032:analysis; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000276:immunology / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies
D000906:Antibodies