{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T09:51:26Z","timestamp":1761126686339},"reference-count":0,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":1095,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Gastroenterology and Hepatology"],"published-print":{"date-parts":[[1997,1]]},"abstract":"<jats:p>Late                             recurrent primary biliary cirrhosis (PBC) following                             orthotopic liver transplant remains a controversial                             topic. The first documented case of recurrence occurring                             in 16 patients transplanted for PBC and followed at                             the authors\u2032 institution for longer than one year is                             presented. A 54\u2010year\u2010old man transplanted for PBC developed                             a cholestatic pattern of enzyme elevation on post\u2010transplant                             day (PTD) 1305. Repeat antimitochondrial antibody was                             strongly positive (1:300 to 1:400). A liver biopsy revealed                             severe bile duct damage, lymphocytic cholangitis, focal                             periductal noncaseating granuloma and minimal endotheliitis.                             Recurrent PBC was diagnosed. At the time of orthotopic                             liver transplant this patient received induction immunosuppression                             with OKT3 crossed over to cyclosporine (CsA), azathioprine                             (AZA) and prednisone. AZA was discontinued early and                             maintenance CsA tapered to a target trough level of                             150 to 200 ng\/mL by PTD 365. Prednisone was withdrawn                             by PTD 664. CsA levels during PTDs 1225 to 1305 (before                             elevation of hepatobiliary enzymes) were below target                             at 114 to 166 ng\/mL. Of the 16 patients, all but three                             were maintained on CsA, AZA and prednisone. One was                             on CsA (trough levels on target) and AZA; the other                             two, including the patient with recurrent PBC, were                             on CsA only. The trough CsA level of the patient without                             recurrent PBC has been within the target range. The                             authors speculate that the underlying defect in immunoregulation                             in PBC persists post\u2010transplant and that in the patient                             without recurrent PBC this defect was unmasked by lowered                             maintenance immunosuppression \u2010 allowing recurrence                             of PBC in a previously stable liver allograft.<\/jats:p>","DOI":"10.1155\/1997\/790906","type":"journal-article","created":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T21:22:18Z","timestamp":1459459338000},"page":"229-233","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Late Recurrent Post\u2010Transplant Primary Biliary Cirrhosis in British Columbia"],"prefix":"10.1155","volume":"11","author":[{"given":"Eric M","family":"Yoshida","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R Andrew","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert K","family":"Vartanian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A","family":"Owen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siegfried R","family":"Erb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles H","family":"Scudamore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1997,4]]},"container-title":["Canadian Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/1997\/790906.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/1997\/790906","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T09:08:21Z","timestamp":1722330501000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/1997\/790906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,1]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1997,1]]}},"alternative-id":["10.1155\/1997\/790906"],"URL":"https:\/\/doi.org\/10.1155\/1997\/790906","archive":["Portico"],"relation":{},"ISSN":["2291-2789","2291-2797"],"issn-type":[{"type":"print","value":"2291-2789"},{"type":"electronic","value":"2291-2797"}],"subject":[],"published":{"date-parts":[[1997,1]]},"assertion":[{"value":"1996-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-05-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-04-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}