Document Detail


Association of hepatic artery stenosis and biliary strictures in liver transplant recipients.
MedLine Citation:
PMID:  21455929     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Biliary complications are an important cause of morbidity and graft failure in patients following orthotopic liver transplantation. Nonanastomotic biliary strictures (NAS) are frequently the most challenging biliary complication. Hepatic artery stenosis (HAS) as a cause of biliary strictures has not been studied well systematically. We performed a retrospective cohort study of patients who received liver transplantation at our institution between the 1995 and 2007 for the incidence of biliary strictures (NAS and anastomotic) with HAS. 40 patients were identified and compared with 62 matched non-HAS control patients. Overall, NAS and biliary anastomotic strictures were seen more frequently in 24 of 40 (60%) patients with HAS compared to 6 of 62(9.67%) control patients (p<0.000001). Cholangiographic evidence for NAS was seen in 10 of 40 study patients (25%) and 1 of 62 control patients (2%) (p <0.0001) while evidence of biliary anastomotic stricture was seen in 14 of 40 (35%) study patients and 5 of 62 (8%) control patients (p=.0006). Cold ischemia time was also found to be associated with the presence of NAS in patients with HAS (p=0.02). Patients with biliary strictures were generally managed successfully with ERCP balloon dilation/stenting, except for 4 NAS patients who had significant morbidity/mortality. In conclusion, the development of HAS, particularly with prolonged cold ischemic time, may increase the risk of NAS after liver transplantation. HAS is also associated with the development of biliary anastomotic strictures. Prospective studies with frequent arterial monitoring for early detection and intervention of HAS to prevent biliary complications are needed. Liver Transpl, 2011. © 2011 AASLD.
Authors:
Sunil Dacha; Ashis Barad; John Martin; Josh Levitsky
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-31
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  -     ISSN:  1527-6473     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-4-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Association for the Study of Liver Diseases.
Affiliation:
Saint Joseph Hospital, Chicago, Illinois.
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