Caroli disease patients have excellent survival after liver transplant

Theresa R. Harring, N. Thao T. Nguyen, Hao Liu, John A. Goss, Christine A. O'Mahony

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Caroli disease (CD) is characterized by dilation of the intrahepatic biliary tree, which may result in malignancy. Treatments include management of symptoms and hepatic resection to decrease disease burden. In patients with CD not amenable to these treatments, orthotopic liver transplantation (OLT) has been used. This study examines if OLT is a reasonable treatment for patients with CD. Materials and methods: The United Network of Organ Sharing/Organ Procurement and Transplantation Network database between September 30, 1987 and March 31, 2011 was queried. Cases without patient or allograft survival time or without a diagnosis were excluded from analysis. Patients with CD were compared to patients with primary biliary cirrhosis (PBC), secondary biliary cirrhosis (BC), primary sclerosing cholangitis (PSC), and all indications for OLT. Survival analysis was performed by log-rank test and Kaplan-Meier. Results: One hundred forty patients with CD were compared to 4797 patients with PBC, 489 patients with secondary BC, 6033 patients with PSC, and 92,210 patients post-OLT. Patient and allograft survivals of CD patients at 1, 3, 5, and 10 y are, respectively, 88.5%, 83.4%, 80.9%, and 77.8%; and 81.2%, 74.8%, 70.6%, and 67.9%. CD patients have significantly improved patient and allograft survivals after OLT compared to patients with secondary BC (P = 0.003, P = 0.015) and all other patients undergoing OLT (P = 0.003, P = 0.026). There is a trend towards long-term improved patient and allograft survival in transplanted patients with CD compared to patients with PBC and PSC. Conclusions: These results suggest that OLT should be considered an effective treatment modality for patients with CD resulting in excellent long-term outcomes.

Original languageEnglish (US)
Pages (from-to)365-372
Number of pages8
JournalJournal of Surgical Research
Volume177
Issue number2
DOIs
StatePublished - Oct 1 2012
Externally publishedYes

Fingerprint

Caroli Disease
Transplants
Survival
Liver
Biliary Liver Cirrhosis
Liver Transplantation
Sclerosing Cholangitis
Allografts

Keywords

  • Biliary dilatation
  • Choledochal cyst type V
  • Intrahepatic
  • Orthotopic
  • Outcomes

ASJC Scopus subject areas

  • Surgery

Cite this

Caroli disease patients have excellent survival after liver transplant. / Harring, Theresa R.; Nguyen, N. Thao T.; Liu, Hao; Goss, John A.; O'Mahony, Christine A.

In: Journal of Surgical Research, Vol. 177, No. 2, 01.10.2012, p. 365-372.

Research output: Contribution to journalArticle

Harring, Theresa R. ; Nguyen, N. Thao T. ; Liu, Hao ; Goss, John A. ; O'Mahony, Christine A. / Caroli disease patients have excellent survival after liver transplant. In: Journal of Surgical Research. 2012 ; Vol. 177, No. 2. pp. 365-372.
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abstract = "Background: Caroli disease (CD) is characterized by dilation of the intrahepatic biliary tree, which may result in malignancy. Treatments include management of symptoms and hepatic resection to decrease disease burden. In patients with CD not amenable to these treatments, orthotopic liver transplantation (OLT) has been used. This study examines if OLT is a reasonable treatment for patients with CD. Materials and methods: The United Network of Organ Sharing/Organ Procurement and Transplantation Network database between September 30, 1987 and March 31, 2011 was queried. Cases without patient or allograft survival time or without a diagnosis were excluded from analysis. Patients with CD were compared to patients with primary biliary cirrhosis (PBC), secondary biliary cirrhosis (BC), primary sclerosing cholangitis (PSC), and all indications for OLT. Survival analysis was performed by log-rank test and Kaplan-Meier. Results: One hundred forty patients with CD were compared to 4797 patients with PBC, 489 patients with secondary BC, 6033 patients with PSC, and 92,210 patients post-OLT. Patient and allograft survivals of CD patients at 1, 3, 5, and 10 y are, respectively, 88.5{\%}, 83.4{\%}, 80.9{\%}, and 77.8{\%}; and 81.2{\%}, 74.8{\%}, 70.6{\%}, and 67.9{\%}. CD patients have significantly improved patient and allograft survivals after OLT compared to patients with secondary BC (P = 0.003, P = 0.015) and all other patients undergoing OLT (P = 0.003, P = 0.026). There is a trend towards long-term improved patient and allograft survival in transplanted patients with CD compared to patients with PBC and PSC. Conclusions: These results suggest that OLT should be considered an effective treatment modality for patients with CD resulting in excellent long-term outcomes.",
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AU - Liu, Hao

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AB - Background: Caroli disease (CD) is characterized by dilation of the intrahepatic biliary tree, which may result in malignancy. Treatments include management of symptoms and hepatic resection to decrease disease burden. In patients with CD not amenable to these treatments, orthotopic liver transplantation (OLT) has been used. This study examines if OLT is a reasonable treatment for patients with CD. Materials and methods: The United Network of Organ Sharing/Organ Procurement and Transplantation Network database between September 30, 1987 and March 31, 2011 was queried. Cases without patient or allograft survival time or without a diagnosis were excluded from analysis. Patients with CD were compared to patients with primary biliary cirrhosis (PBC), secondary biliary cirrhosis (BC), primary sclerosing cholangitis (PSC), and all indications for OLT. Survival analysis was performed by log-rank test and Kaplan-Meier. Results: One hundred forty patients with CD were compared to 4797 patients with PBC, 489 patients with secondary BC, 6033 patients with PSC, and 92,210 patients post-OLT. Patient and allograft survivals of CD patients at 1, 3, 5, and 10 y are, respectively, 88.5%, 83.4%, 80.9%, and 77.8%; and 81.2%, 74.8%, 70.6%, and 67.9%. CD patients have significantly improved patient and allograft survivals after OLT compared to patients with secondary BC (P = 0.003, P = 0.015) and all other patients undergoing OLT (P = 0.003, P = 0.026). There is a trend towards long-term improved patient and allograft survival in transplanted patients with CD compared to patients with PBC and PSC. Conclusions: These results suggest that OLT should be considered an effective treatment modality for patients with CD resulting in excellent long-term outcomes.

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