title: Long-Term Outcomes of Liver Transplantation for Hepatic Sarcoidosis: A Single Center Experience.
abstract: OBJECTIVE
  Hepatic sarcoidosis is a rare indication for orthotopic liver transplantation (OLT). Hence, studies evaluating these patients are scarce. We present a single center experience with OLT for hepatic sarcoidosis in a case-control study.
  
  
  METHODS
  A retrospective chart review was performed on 970 patients with OLT at our center, and 13 patients (1.3%) were identified who underwent 14 OLTs for hepatic sarcoidosis. For each case, two controls matched for etiology of liver disease, recipient age (±5 years), and duration since transplant (within 5 years) were selected.
  
  
  RESULTS
  For the 13 patients transplanted for sarcoidosis, the median age was 46 years. The majority were women (62%) and African-American (85%). Cholestatic liver disease was the primary manifestation. Portal hypertensive complications were present in 11 patients (84%). The median MELD score at transplantation was 19. Extra-hepatic manifestations were present in ten patients (77%). All patients received whole deceased 14 donor allografts. Six patients remain alive with a median post-OLT follow-up of 8.4 years. The 1-, 3-, 5-, and 10-year patient survival rates were 84.6%, 76.9%, 61.1%, and 51.3%, respectively for the sarcoidosis group and 82.1%, 78.6%, 78.6%, and 61.9%, respectively for the matched PSC/PBC group (P = 0.739). Re-graft free survival for sarcoidosis patients was 84.6%, 76.9%, 61.5%, and 51.3% for 1-, 3-, 5-, and 10-years and for the matched control group re-graft free survival was 78.6% at 1-, 3-, 5-years, and 64.8% at 10-years (P = 0.661). Recurrence of hepatic sarcoidosis was found in 4 patients at 11 days, 112 days, 222 days, and 6.6 years.
  
  
  CONCLUSIONS
  Our study depicts the long-term benefit of liver transplantation in patients with end stage liver disease secondary to sarcoidosis. It shows statistically comparable graft and patient survival for such patients when compared to other cholestatic diseases. Disease recurrence, although possible, has not been shown to cause allograft dysfunction.
authors: Department of Gastroenterology and Hepatology, University of Tennessee Health Sciences Center, Memphis, TN, United States.
authors: Muhammad
authors: M
authors: Bilal
authors: Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN, United States.
authors: Sanjaya K
authors: SK
authors: Satapathy
authors: Department of Gastroenterology and Hepatology, University of Tennessee Health Sciences Center, Memphis, TN, United States.
authors: Mohammad K
authors: MK
authors: Ismail
authors: Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN, United States.
authors: Jason M
authors: JM
authors: Vanatta
keywords: ACE, angiotensin converting enzyme; CTP, Child–Turcotte–Pugh; DM, diabetes mellitus; HCV, hepatitis C virus; MELD, Model for End Stage Liver Disease; OLT, orthotopic liver transplantation; PBC, primary biliary cirrhosis; PSC, primary sclerosing cholangitis; cirrhosis; liver transplantation; portal hypertension; sarcoidosis