[Liver transplantation in patients with primary sclerosing cholangitis.Determining timing with reference to risk of malignancy]

Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease associated with hepatobiliary malignancies which are in the majority of cases not known prior to transplantation. Applying the Mayo PSC natural history model, patients can be classified in low, medium and high risk groups; particularly patients at medium and high risk are in danger of developing malignancies in a PSC setting. Therefore, regular scoring of patients using the above-mentioned model is suggested, and transplantation should be performed at scores above 4.