Primary%20biliary%20cholangitis Treatment
Surgical Intervention
Liver Transplantation
- Liver transplantation is the only life-saving procedure for patients with progressive PBC and consequent liver failure
- Increasing bilirubin and decreasing albumin levels and a prolonged prothrombin time are signs of disease progression
- A referral for a liver transplant evaluation should be done in patients with decompensated cirrhosis, total bilirubin >6 mg/dL, a MELD score of at least 15 and >7.8 from the updated Mayo Clinic Natural History Model for PBC
- Consider liver transplantation in refractory ascites, recurrent spontaneous bacterial peritonitis, recurrent variceal bleeding, hepatic coma, HCC or hepatorenal syndrome type I
- Uncontrollable pruritus resistant to medical therapy may be an indication for liver transplantation
- Patients with PBC recurrence post liver transplant can be given UDCA therapy