What determines the prognosis of primary biliary cholangitis (PBC)?

Updated: Nov 08, 2017
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

The most reliable determinants of patient prognosis in primary biliary cholangitis are the height of the serum bilirubin level and the Mayo risk score.

Note the following:

  • Published reports indicate that, when serum bilirubin values are constantly above 2, the mean survival rate is 4.1 years.

  • When bilirubin levels are constantly above 6 mg/dL, the mean survival rate is 2.1 years.

  • When bilirubin levels are constantly above 10 mg/dL, the mean survival rate is 1.4 years.

  • The Mayo risk score is calculated as follows: R = 0.871 loge (bilirubin in mg/dL) + (–2.53) loge (albumin in g/dL) + 0.039 age in years + 2.38 loge (prothrombin time in seconds) + 0.859 (edema score of 0, 0.5, or 1)

  • A report reassessed the Mayo risk score, taking into consideration other factors found to be important in the timing of transplantation in patients with chronic cholestatic liver disease. Neither the height of the serum bilirubin level nor the Mayo risk score are invalidated by UDCA therapy. Treatment with UDCA before liver transplantation does not alter the posttransplantation outcome.


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