Predictors of Biliary Strictures After Liver Transplantation Among Recipients of DCD (Donation After Cardiac Death) Grafts.
Adult
Age Factors
Bilirubin
/ blood
Biomarkers
/ blood
Cause of Death
Cholangiopancreatography, Endoscopic Retrograde
Cholestasis
/ blood
Female
Heart Diseases
/ mortality
Humans
International Normalized Ratio
Liver Transplantation
/ adverse effects
Male
Middle Aged
Retrospective Studies
Risk Factors
Time Factors
Tissue Donors
Treatment Outcome
Biliary strictures
Donation after cardiac death
Liver transplant
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
30
09
2018
accepted:
15
12
2018
pubmed:
4
1
2019
medline:
24
12
2019
entrez:
4
1
2019
Statut:
ppublish
Résumé
Biliary strictures are a common complication among donation after cardiac death (DCD) liver transplantation (LT) recipients and may require multiple endoscopic retrograde cholangiopancreatography (ERCP) procedures. We evaluated the risk factors associated with development of biliary strictures in DCD LT recipients. DCD LT recipients who underwent transplantation from 2012 to 2017 were divided into 2 groups: (a) those with anastomotic or non-anastomotic biliary strictures who required ERCP ("stricture group") and (b) those who did not require ERCP or had cholangiograms without evidence of biliary strictures ("non-stricture group"). Clinical data, cholangiograms and laboratory values at day 0 and day 7 after LT were compared between the two groups. Forty-nine of the 100 DCD LT recipients underwent ERCP. Thirty-four of these 49 LT recipients had evidence of anastomotic or non-anastomotic biliary strictures (stricture group), while the remaining 66 LT recipients comprised the non-stricture group. Donor age was significantly higher in stricture group compared to non-stricture group (49.2 ± 1.8 vs 42.8 ± 1.57 years, respectively; p = 0.01). The stricture group had a significantly higher total bilirubin at day 0 (3.5 ± 0.37 vs 2.6 ± 0.21 mg/dL; p = 0.02) and INR at day 7 (1.24 ± 0.06 vs 1.13 ± 0.01; p = 0.048) compared to the non-stricture group. Multi-variate analysis demonstrated significant association between biliary strictures and total bilirubin at day 0 of LT and age of donor. Biliary strictures occur frequently in DCD LT recipients and may be associated with older age of donor. Hyperbilirubinemia immediately after transplant and higher INR in the first 7 days after transplant may predict subsequent development of biliary strictures.
Identifiants
pubmed: 30604376
doi: 10.1007/s10620-018-5438-0
pii: 10.1007/s10620-018-5438-0
doi:
Substances chimiques
Biomarkers
0
Bilirubin
RFM9X3LJ49
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2024-2030Commentaires et corrections
Type : CommentIn
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