Native liver xanthogranulomatous cholangiopathy in primary sclerosing cholangitis: Impact on posttransplant outcome

Andrew Paul Keaveny, Fredric David Gordon, Atoussa Goldar-Najafi, William David Lewis, Elizabeth Anne Pomfret, James John Pomposelli, Roger Lewin Jenkins, Urmila Khettry

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

A restrospective analysis of 51 primary sclerosing cholangitis (PSC) patients who underwent liver transplant (LT) identified 16 with xanthogranulomatous cholangiopathy (XGC) at the native liver hilum. Pre-LT clinical and laboratory data and post-LT course and outcome of patients with XGC were compared with the 35 PSC patients without XGC. The XGC and non-XGC groups were similar with respect to age and laboratory data at the time of LT. Pre-LT cholecystectomy was performed in 44% versus 26% and biliary bypass procedure in 38% versus 26% of patients with and without XGC, respectively (P = NS). Peri-operative complications resulted in six (38%) deaths or retransplantation within 60 days of LT in the XGC group compared with 4 (11%) in the non-XGC group (P = .05). Patient survival at 60 and 100 days post-LT was better in the non-XGC group (P = .01). The causes of death or retransplantation within 60 days post-LT in the patients with XGC included primary nongraft function (1), uncontrolled bleeding (3), and sepsis (2), while in the non-XGC group these were uncontrolled bleeding (2), sepsis (1), and primary nongraft function (1). Mean graft survival ± SD was 1,081 ± 1,584 days in patients with XGC versus 2,149 ± 1,679 days in patients without XGC. The presence of XGC in the native liver hilum of PSC patients undergoing LT was associated with a higher rate of early post-LT mortality or retransplantation. In conclusion, no pre-LT clinical features or laboratory tests were identified that predicted the presence of XGC in PSC patients.

Original languageEnglish (US)
Pages (from-to)115-122
Number of pages8
JournalLiver Transplantation
Volume10
Issue number1
DOIs
StatePublished - Jan 1 2004

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

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