Liver Cirrhosis Research Today is a free monthly online journal that collates and summarizes the latest research about Liver Cirrhosis, including details on alcohol, treatment, drugs, effects, causes.

The optimal timing of liver transplantation in patients with chronic cholestatic liver disease.

Rave S, Schalm SW,

Department of Gastroenterology and Hepatology, Section of Liver Diseases and Liver Transplantation, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.

The current opinion is that liver transplantation for chronic cholestatic liver disease should be done before the terminal, high-risk stage. However, most studies do not take waiting list mortality into account. We analysed 113 consecutive patients with chronic cholestatic liver disease, stratified according to estimated survival. Overall and post-transplantation survival was calculated using the Kaplan-Meier method. Including patients who died awaiting transplantation lowered the 1-year survival by 19% in the high-risk category. In this group survival at 4 years was 45%, with an estimated survival benefit of 45%. For the intermediate- and low-risk groups these numbers were 56% and 36% vs. 81% and 7%. Including the waiting list period in the analysis of the benefits of liver transplantation strengthens the case for early transplantation. Our study confirms that liver transplantation should be considered before the high-risk stage of chronic cholestatic liver disease is reached.

Published 12 July 2005 in Transpl Int, 18(8): 937-40.
Full-text of this article is available online (may require subscription).

© 2004-2008 Liver Cirrhosis Research Today. All Rights Reserved.