Risk factors and clinical indicators for the development of biliary strictures post liver transplant: Significance of bilirubin
To identify risk factors associated with the formation of biliary strictures post liver transplantation over a period of 10-year in Queensland. Data on liver donors and recipients in Queensland between 2005 and 2014 was obtained from an electronic patient data system. In addition, intra-operative an...
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| Published in: | World journal of transplantation Vol. 7; no. 6; pp. 349 - 358 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Baishideng Publishing Group Inc
24-12-2017
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | To identify risk factors associated with the formation of biliary strictures post liver transplantation over a period of 10-year in Queensland.
Data on liver donors and recipients in Queensland between 2005 and 2014 was obtained from an electronic patient data system. In addition, intra-operative and post-operative characteristics were collected and a logistical regression analysis was performed to evaluate their association with the development of biliary strictures.
Of 296 liver transplants performed, 285 (96.3%) were from brain dead donors. Biliary strictures developed in 45 (15.2%) recipients. Anastomotic stricture formation (
= 25, 48.1%) was the commonest complication, with 14 (58.3%) of these occurred within 6-mo of transplant. A percutaneous approach or endoscopic retrograde cholangiography was used to treat 17 (37.8%) patients with biliary strictures. Biliary reconstruction was initially or ultimately required in 22 (48.9%) patients. In recipients developing biliary strictures, bilirubin was significantly increased within the first post-operative week (Day 7 total bilirubin 74 μmol/L
49 μmol/L,
= 0.012). In both univariate and multivariate regression analysis, Day 7 total bilirubin > 55 μmol/L was associated with the development of biliary stricture formation. In addition, hepatic artery thrombosis and primary sclerosing cholangitis were identified as independent risk factors.
In addition to known risk factors, bilirubin levels in the early post-operative period could be used as a clinical indicator for biliary stricture formation. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Author contributions: Forrest EA, Reiling J and Fawcett J designed the research; Forrest EA, Reiling J and Lipka G performed the research; Forrest EA and Reiling J analyzed the data; Forrest EA wrote the paper; Reiling J, Lipka G and Fawcett J revised the manuscript prior to submission. Correspondence to: Elizabeth Ann Forrest, MD, BSc BA, Resident Medical Officer, Department of Surgery, Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport, Gold Coast, Queensland 4215, Australia. elizabeth.forrest3@health.qld.gov.au Telephone: +61-7-56870000 Fax: +61-7-56870098 |
| ISSN: | 2220-3230 2220-3230 |
| DOI: | 10.5500/wjt.v7.i6.349 |