Association between indocyanine green clearance test and ischemic type biliary lesions within one year after orthotopic liver transplantation.
Biliary Tract
/ blood supply
Coloring Agents
/ pharmacokinetics
Constriction, Pathologic
/ blood
Female
Humans
Immunosuppressive Agents
/ therapeutic use
Indocyanine Green
/ pharmacokinetics
Ischemia
/ complications
Liver Transplantation
/ adverse effects
Male
Middle Aged
Postoperative Complications
/ blood
Reperfusion Injury
/ blood
Spectrophotometry
Steroids
/ therapeutic use
Time Factors
Biliary complications
IRI
ITBL
Indocyanine green
Ischemia–reperfusion injury
Lesiones biliares de tipo isquémico
Lesión por isquemia-reperfusión
Liver transplantation
NAS
Trasplante de hígado
Verde de indocianina
Journal
Gastroenterologia y hepatologia
ISSN: 0210-5705
Titre abrégé: Gastroenterol Hepatol
Pays: Spain
ID NLM: 8406671
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
20
12
2020
revised:
03
03
2021
accepted:
29
03
2021
pubmed:
24
5
2021
medline:
4
2
2022
entrez:
23
5
2021
Statut:
ppublish
Résumé
Ischemic type biliary lesions (ITBLs), a particular subset of non-anastomotic biliary strictures (NAS), are characterized by intra and extrahepatic strictures that occur in the absence of either hepatic artery thrombosis or stenosis. When they occur within the first year after liver transplantation their development is mostly related to ischemia-reperfusion injury (IRI). The indocyanine green plasma disappearance rate (ICG-PDR) might be able to predict the probability of IRI-induced graft damage after liver transplantation. Our aim was to evaluate the association between ICG-PDR and the occurrence of ITBLs. Secondly, we searched for evidence of IRI in patients presenting ITBLs. This retrospective single-center observational study assessed a cohort of 60 liver transplant patients. Each patient underwent ICG-PDR on the 1st postoperative day. ITBLs were identified by means of either cholangiography or magnetic resonance imaging evidence of a deformity and narrowing of the biliary tree in the absence of hepatic artery thrombosis/stenosis. ITBLs were discovered in 10 patients out of 60 liver recipients (16.67%) within one year after transplantation. A low ICG-PDR value was found to be a significant predictive factor for ITBL development, with an OR of 0.87 and a 95% CI of 0.77-0.97. Liver biopsies were performed in 56 patients presenting unexplained abnormal liver function test results. A statistically significant association was found between the development of ITBLs and anatomopathological evidence of IRI. Retrospective, single-center study. The findings from this study show a relationship between low ICG-PDR values on first post-operative-day and the occurrence of ITBLs within 1 year after transplantation.
Sections du résumé
BACKGROUND
BACKGROUND
Ischemic type biliary lesions (ITBLs), a particular subset of non-anastomotic biliary strictures (NAS), are characterized by intra and extrahepatic strictures that occur in the absence of either hepatic artery thrombosis or stenosis. When they occur within the first year after liver transplantation their development is mostly related to ischemia-reperfusion injury (IRI). The indocyanine green plasma disappearance rate (ICG-PDR) might be able to predict the probability of IRI-induced graft damage after liver transplantation.
OBJECTIVE
OBJECTIVE
Our aim was to evaluate the association between ICG-PDR and the occurrence of ITBLs. Secondly, we searched for evidence of IRI in patients presenting ITBLs.
METHODS
METHODS
This retrospective single-center observational study assessed a cohort of 60 liver transplant patients. Each patient underwent ICG-PDR on the 1st postoperative day. ITBLs were identified by means of either cholangiography or magnetic resonance imaging evidence of a deformity and narrowing of the biliary tree in the absence of hepatic artery thrombosis/stenosis.
RESULTS
RESULTS
ITBLs were discovered in 10 patients out of 60 liver recipients (16.67%) within one year after transplantation. A low ICG-PDR value was found to be a significant predictive factor for ITBL development, with an OR of 0.87 and a 95% CI of 0.77-0.97. Liver biopsies were performed in 56 patients presenting unexplained abnormal liver function test results. A statistically significant association was found between the development of ITBLs and anatomopathological evidence of IRI.
LIMITATIONS
CONCLUSIONS
Retrospective, single-center study.
CONCLUSIONS
CONCLUSIONS
The findings from this study show a relationship between low ICG-PDR values on first post-operative-day and the occurrence of ITBLs within 1 year after transplantation.
Identifiants
pubmed: 34023468
pii: S0210-5705(21)00146-1
doi: 10.1016/j.gastrohep.2021.03.005
pii:
doi:
Substances chimiques
Coloring Agents
0
Immunosuppressive Agents
0
Steroids
0
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Observational Study
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
687-695Informations de copyright
Copyright © 2021 Elsevier España, S.L.U. All rights reserved.