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The Possible Effects of Ursodeoxycholic Acid on Recurrent Primary Biliary Cholangitis and Biliary Complications After Liver Transplant.

MP Several randomized controlled trials and analyses have shown that ursodeoxycholic acid (UDCA) delays histologic progression and prolongs transplant-free survival in patients with primary biliary cholangitis (PBC). Response to UDCA at 1 year gives a sense of how patients will do, with response defined as improvement in alkaline phosphatase. Although the exact cutoff may vary from study to study, a serum alkaline phosphatase of less than twice the upper limit of normal is a good predictor of treatment response. Adequate response to UDCA occurs in approximately 60% of patients with PBC, which means that it does not occur in 40% of patients. Without adequate response, the median transplant-free survival at 10 years is approximately 50% to 70% in asymptomatic patients and lower in symptomatic patients. With adequate response, survival is fairly similar to that of an average person.