Radiology, Vol 169, 641-642, Copyright © 1988 by Radiological Society of North America
Recurrent cholangiocarcinoma in the biliary tree after liver transplantation
T Herbener, AB Zajko, B Koneru, KM Bron and WL Campbell
Department of Radiology, University of Pittsburgh School of Medicine, PA.
Four liver transplant recipients with recurrent cholangiocarcinoma (CCA)
within the allograft biliary tree are described. One patient received a
transplant for known CCA and three received transplants for end-stage
primary sclerosing cholangitis, in which CCA was found within the
hepatectomy specimen. All four developed biliary obstruction due to
malignant stricture at the bile duct anastomosis 9-15 months after
transplantation. Diagnosis of recurrent CCA was made by means of
transhepatic brush biopsy in two patients. Recognition that the biliary
tract, especially the anastomosis, is a site of recurrence of CCA should
facilitate prompt diagnosis by means of transhepatic brush biopsy in
patients with biliary obstruction due to stricture. In addition, because of
an association between CCA and primary sclerosing cholangitis, preoperative
bile duct biopsy should be considered for liver transplantation candidates
with the latter condition. Positive biopsy findings may preclude
transplantation.
