The revival of preemptive UDCA therapy in liver transplant recipients Commentary to ‘‘UDCA decreases Incidence of Primary Biliary Cholangitis and Biliary Complications after Liver Transplant: A Meta-Analysis’’ by Pedersen et al., Liver Transplant, November 2020

摘要

Ursodeoxycholic acid (UDCA) is a natural hydrophilic bile acid (7 beta-hydroxy isomer of chenodeoxycholic acid) present in very small quantities (<5 of all bile acid species) in human bile. When administered orally on a daily basis, it becomes the main (up to 70) circulating bile acid in both blood and bile and exerts a number of beneficial effects in various liver dysfunctions such as cholestasis, cholelithiasis, and hepatobiliary inflammation. The two main approved indications of UDCA are cholesterol gallstone dissolution and treatment of primary biliary cholangitis (PBC), a progressive, autoimmune cholestatic liver disease, characterized by inflammation and destruction of small intrahepatic bile ducts leading to cirrhosis, liver failure and premature death if untreated. UDCA prolongs survival free of liver transplantation (LT) of patients with PBC 1.