Document Detail

Long-term clinical outcome of biliary cast syndrome in liver transplantation recipients.
MedLine Citation:
PMID:  23213039     Owner:  NLM     Status:  Publisher    
Biliary cast syndrome (BCS) is uncommon complication of orthotopic liver transplantation (OLT), thus long-term treatment outcome of BCS is not well characterized. The purpose of this study was to evaluate long-term treatment outcome and prognosis of BCS after OLT. Between January 2000 and September 2009, medical records of 1097 patients who underwent OLT were reviewed. Of them, the patients who had BCS were evaluated for treatment method, overall survival, relapse and relapse free time. Twenty-three patients (2.1%) were diagnosed BCS with a median overall follow-up of 65.4 months. All the patients had benign biliary stricture and underwent balloon dilatations repeatedly by endoscopic or percutaneous approaches. Casts were removed with endoscopic method in 4 patients (17%), with percutaneous transhepatic method in 11 patients (48%), and with both methods in 8 patients (35%). Casts were completely removed by repetitive procedures in 22 patients, but BCS relapsed in 12 patients (55%) and relapse free time was 26.7 months. Persistent biliary stricture was significantly associated with relapse frequency of BCS (0.37 versus 0.05 time/year, P=0.006). Five-year overall survival rate of BCS patients after OLT was 87%. Risk factors associated with early relapse were female, hepatic artery stenosis and acute cellular rejection. In multivariate analysis, acute cellular rejection was the only significant risk factor of early relapse (HR 11.1, 95% CI 1.9-63.2, P=0.007). In conclusion, BCS is frequently relapsed, and multiple interventions and treatment of biliary strictures are needed. Acute cellular rejection after OLT is the significant risk factor of early relapse. © 2012 American Association for the Study of Liver Diseases.
Woo Hyun Paik; Sang Hyub Lee; Ji Kon Ryu; Byeong Jun Song; Jaihwan Kim; Yong-Tae Kim; Yong Bum Yoon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-5
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:  Liver Transpl.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-5     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 © 2012 American Association for the Study of Liver Diseases.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Korea.
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