Fosby B, Karlsen TH, Melum E. Recurrence and rejection in liver transplantation for primary sclerosing cholangitis. World J Gastroenterol 2012; 18(1): 1-15 [PMID: 22228965 DOI: 10.3748/wjg.v18.i1.1]
Corresponding Author of This Article
Espen Melum, MD, PhD, Norwegian primary sclerosing cholangitis Research Center, Clinic for Specialized Medicine and Surgery, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway. espen.melum@medisin.uio.no
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 7, 2012; 18(1): 1-15 Published online Jan 7, 2012. doi: 10.3748/wjg.v18.i1.1
Recurrence and rejection in liver transplantation for primary sclerosing cholangitis
Bjarte Fosby, Tom H Karlsen, Espen Melum
Bjarte Fosby, Department of Transplantation Surgery, Clinic for Specialized Medicine and Surgery, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway
Bjarte Fosby, Tom H Karlsen, Espen Melum, Norwegian Primary Sclerosing cholangitis Research Center, Clinic for Specialized Medicine and Surgery, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway
Espen Melum, Research Institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway
Author contributions: Fosby B searched the literature for relevant articles; Fosby B and Melum E wrote the paper; Karlsen TH critically evaluated and edited the manuscript; All authors approved the final manuscript.
Correspondence to: Espen Melum, MD, PhD, Norwegian primary sclerosing cholangitis Research Center, Clinic for Specialized Medicine and Surgery, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway. espen.melum@medisin.uio.no
Telephone: +47-91780732 Fax: +47-23074869
Received: April 23, 2011 Revised: June 15, 2011 Accepted: June 22, 2011 Published online: January 7, 2012
Abstract
Primary sclerosing cholangitis (PSC) is a chronic progressive inflammatory disease affecting the bile ducts, leading to fibrosis and eventually cirrhosis in most patients. Its etiology is unknown and so far no effective medical therapy is available. Liver transplantation (LTX) is the only curative treatment and at present PSC is the main indication for LTX in the Scandinavian countries. Close to half of the PSC patients experience one or more episodes of acute cellular rejection (ACR) following transplantation and approximately 1/5 of the transplanted patients develop recurrent disease in the graft. In addition, some reports indicate that ACR early after LTX for PSC can influence the risk for recurrent disease. For these important post-transplantation entities affecting PSC patients, we have reviewed the current literature on epidemiology, pathogenesis, treatment and the possible influence of rejection on the risk of recurrent disease in the allograft.
