To evaluate the safety and clinical effect of liver transplantation for treating primary biliary cirrhosis (PBC).

The clinical data of 8 cases with PBC who underwent liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from September 2003 to July 2009 were analyzed retrospectively. Local ethical committee approval had been received and that the informed consent of all participating subjects was obtained. All the patients were female, aged from 39 to 63 years old with an average age of 52 years old. The Child-Pugh grade was B in 2 cases and C in 6 cases. The model for end-stage liver disease (MELD) scores of the 8 patients was 18-28. All the patients received modified piggyback liver transplantation with venacavaplasty and joint/triple immunosuppressive regimen of tacrolimus or cyclosporine A plus prednisone after operation. Mycophenolate mofetil was also applied in 3 patients at the same time. The duration of the operation, anhepatic phase time, volume of intraoperative bleeding and the postoperative hospital stay were recorded. The occurrences of their perioperative complications and death were observed. The operative complications, recurrences of PBC and survival time were investigated during follow up.

The operations of all the patients were successful. The duration of the operation was (364±100) min. The anhepatic phasetime was (38±11) min. The volume of intraoperative bleeding was (1 875±525) ml. The postoperative hospital stay was 37-154 d with the median of 84 d. One patient died of lung infection and multiple organ failure 5 d after operation. Three patients suffered from episodes of acute cellular rejection within 1 month after operation but were cured when immunosuppressive therapy strengthened. The 7 survived patients were followed up from 28 months to 92 months with the median follow-up time of 51 months. One patient died of sepsis and graft dysfunction 964 d after operation and the other 6 patients survived. Three cases had survived for 3-4 years and 3 cases more than 5 years.

Liver transplantation is a safe and effective treatment for PBC. Optimum timing of operation and effective immunosuppressive regimen are the key to improving clinical efficacy of liver transplantation.