Miles and Shirley Fitterman Center for Digestive Diseases.
William J. Von Liebig Transplant Center, Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, MN.
Am J Transplant. 2010 Apr;10(4):720-726. doi: 10.1111/j.1600-6143.2010.03038.x. Epub 2010 Feb 25.
Recurrent primary biliary cirrhosis (PBC) is an important clinical outcome after liver transplantation (LT) in selected patients. Prevalence rates for recurrent PBC (rPBC) reported by individual LT programs range between 9% and 35%. The diagnostic hallmark of rPBC is histologic identification of granulomatous changes. Clinical and biochemical features are frequently absent with rPBC and cannot be used alone for diagnostic purposes. Some of the risk factors of rPBC may include recipient factors such as age, gender, HLA status and immunosuppression, as well as donor factors such as age, gender and ischemic time, although controversy exists. Most patients have early stage disease at the time of diagnosis, and there may be a role for therapy with ursodeoxycholic acid. While short- and medium-term outcomes remain favorable, especially if compared to patients transplanted for other indications, continued follow-up may identify reduced long-term graft and patient survival.
复发原发性胆汁性胆管炎（PBC）是选定患者肝移植（LT）后的一个重要临床转归。个别 LT 项目报告的复发 PBC（rPBC）患病率在 9%至 35%之间。rPBC 的诊断标志是组织学识别肉芽肿变化。rPBC 常无临床和生化特征，不能单独用于诊断目的。rPBC 的一些危险因素可能包括受者因素，如年龄、性别、HLA 状态和免疫抑制，以及供者因素，如年龄、性别和缺血时间，但存在争议。大多数患者在诊断时处于早期阶段，熊去氧胆酸治疗可能有一定作用。虽然短期和中期结果仍然良好，尤其是与因其他指征而接受移植的患者相比，但持续随访可能会发现长期移植物和患者生存率降低。
