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Were you one of the many hepatologists or txp surgeons who wondered if you should start UDCA in a transplanted patient with PBC? Well, rest assured my friend and read on.
https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/lt.25935#.X7PqZWhGT8w.twitter
https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/lt.25935#.X7PqZWhGT8w.twitter
UDCA Decreases Incidence of Primary Biliary Cholangitis and Biliary Complications after Liver Transplant: A Meta-Analysis - by Pedersen et al from @UTSWNews.
15 studies
530 pts for biliary complications
1,727 for recurrent PBC
15 studies530 pts for biliary complications1,727 for recurrent PBC
UDCA
biliary complications (OR 0.70), stones and sludge (OR 0.49), but not biliary strictureUDCArate of recurrent PBC (13% vs. 34%)
Here a cool plot showing prophylactic UDCA and median time to recurrence for PBC.
This is incredibly important work that echoes the findings recently published by Corpechot and Global PBC Study Group in @JHepatology showing preventive UDCA post-LT reduces recurrent disease.
https://www.journal-of-hepatology.eu/article/S0168-8278(20)30205-1/abstract#.X7Ps-ZiIg6k.twitter
https://www.journal-of-hepatology.eu/article/S0168-8278(20)30205-1/abstract#.X7Ps-ZiIg6k.twitter
Similar to the study by Corpechot et al, cyclosporine was the preferred calcineurin over FK.
You just performed an uncomplicated transplant on a patient with decompensated PBC. Which calcineurin inhibitor do you choose for immunosuppression? @DrLiver @drbobbybrown @VatcheAgopianMD @elizabeth_verna @LizzieAbyMD @The__Liver @serperm @DebbieShawcros1
