Outcomes of patients with primary sclerosing cholangitis after liver transplantation in a predominantly living donor liver transplant center

The number of studies reporting in detail the complications that occur after liver transplantation in patients with primary sclerosing cholangitis (PSC), especially after living donor liver transplantation (LDLT), is limited. In this study we present the complications and outcomes of PSC patients after liver transplantation in a predominantly LDLT center. Adult and pediatric patients who underwent liver transplantation for PSC between February 2008 and October 2020 were included in the study. The demographic characteristics, presence of co-existing diseases, indications for transplantation, type of transplantation, and immunosuppressive treatments used were recorded. Patient survival, survival times, cause of death, recurrences, rejection, and biliary complications were recorded. Thirty patients who underwent liver transplantation for PSC were included in the study. Twenty-seven patients (90%) were living donor transplants. The 1-, 3-, and 5-year survival rates after transplantation were 75.9%, 74.9%, and 74.9%, respectively. Biliary complications occurred in 15 patients (50%). All patients with biliary complications were successfully treated with endoscopic and percutaneous interventional treatments. Chronic rejection occurred in three patients (10%) and acute rejection occurred in five patients (13.3%). PSC recurrence developed in five patients (18.5%). Biliary complications are the most common complication after liver transplantation in patients with PSC in our center, where LDLT is used extensively and PSC patients are followed closely with respect to biliary complications after transplantation.