Ischemic‐type biliary complications after orthotopic liver transplantation

Nonanastomotic biliary strictures that involve only the biliary tree of the graft occur after orthotopic liver transplantation in patients with hepatic artery thrombosis, chronic ductopenic rejection and ABO blood group incompatibility. This complication may also occur in the absence of these known...

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Bibliographic Details
Published in:Hepatology (Baltimore, Md.) Md.), 1992-07, Vol.16 (1), p.49-53
Main Authors: Sanchez‐Urdazpal, Luis, Gores, Gregory J., Ward, Ellen M., Maus, Timothy P., Wahlstrom, H. Erik, Moore, S. Breanndan, Wiesner, Russell H., Krom, Ruud A. F.
Format: Article
Language:English
Subjects:
Adenosine
Adult
Allopurinol
Biological and medical sciences
Child
Cholangiography
Gallbladder - blood supply
Glutathione
Humans
Hypertonic Solutions
Insulin
Ischemia - diagnostic imaging
Ischemia - etiology
Liver Transplantation
Medical sciences
Organ Preservation - adverse effects
Organ Preservation Solutions
Postoperative Complications - etiology
Raffinose
Retrospective Studies
Risk Factors
Solutions
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
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Summary:Nonanastomotic biliary strictures that involve only the biliary tree of the graft occur after orthotopic liver transplantation in patients with hepatic artery thrombosis, chronic ductopenic rejection and ABO blood group incompatibility. This complication may also occur in the absence of these known risk factors. The major focus of our study was to evaluate the risk factors for nonanastomotic biliary stricturing of unknown cause after orthotopic liver transplantation. Results demonstrate that the development of biliary strictures is strongly associated with the duration of cold ischemic storage of allografts in both Euro‐Collins solution and University of Wisconsin solution. Results also demonstrate that strictures are not associated with the type of biliary reconstruction, the primary liver disease, cytomegalovirus infection, allograft rejection or the presence of a positive lymphocytotoxic crossmatch. More recently, we have markedly reduced the occurrence of nonanastomotic biliary stricturing by decreasing the ischemia time of our allografts. Thus nonanastomotic biliary strictures appear to be the result of the ischemia/reperfusion–induced tissue injury associated with the harvest and implantation of allografts. (HEPATOLOGY 1992;16:49–53.)
ISSN:0270-9139
1527-3350
DOI:10.1002/hep.1840160110