Does long-term remission by endoscopic treatment modalities benefit patient and graft survival in biliary strictures after liver transplantation?

2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
M Heinemann ◽  
B Tafrishi ◽  
S Pischke ◽  
L Fischer ◽  
T Rösch ◽  
...  
Author(s):  
Alexey V. Kurenkov ◽  
Yury S. Teterin ◽  
Oleg D. Olisov ◽  
Petr A. Yartsev ◽  
Murad S. Novruzbekov ◽  
...  

Aim:to improve the results of treating patients with anastomotic biliary strictures of the bile ducts after orthotopic liver transplantation.Materials and methods.This study is based on the results of the endoscopic treatment of 36 patients with biliary complications after orthotopic liver transplantation, who were admitted to the N.V. Sklifosovsky Research Institute for Emergency Medicine from December 2001 to December 2017. The endoscopic treatment program included diagnostic ERCP, endoscopic papillosphincterotomy (EPST), bilioduodenal stenting, nasobiliary drainage, balloon dilatation.Results.Against the background of the staged endoscopic treatment, the stable remission of anastomotic biliary strictures (ABS) was achieved in 17 (53.1 %) patients, with 4 of them (12.5 %) showing a successfully resolved insufficiency of biliobiliary anastomosis (BBA). The average duration of endoscopic treatment was 12 ± 1.9 months. The number of ERCPs performed for each patient varied from 1 to 12 and averaged 3. In the majority of patients (75 %) who received one or more courses of endoscopic treatment, a successful correction of anastomotic strictures with no recurrence within 2–5 years was achieved.Conclusion.Staged endoscopic treatment is established to be highly effective in patients with anastomotic biliary strictures and the insufficiency of bilobiliary anastomoses occurred after orthotopic liver transplantation. Such a treatment allows good long-term results to be achieved by a minimally invasive method.


2020 ◽  
Vol 73 ◽  
pp. S21-S22
Author(s):  
Melina Heinemann ◽  
René Adam ◽  
Marina Berenguer Haym ◽  
Darius F. Mirza ◽  
Seyed Ali Malek-Hosseini ◽  
...  

2012 ◽  
Vol 94 (10S) ◽  
pp. 416
Author(s):  
O. Caso ◽  
I. Justo ◽  
A. Manrique ◽  
N. Fakih ◽  
R. Sanabria ◽  
...  

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 641
Author(s):  
Christoph Leiskau ◽  
Norman Junge ◽  
Eva-Doreen Pfister ◽  
Imeke Goldschmidt ◽  
Frauke Mutschler ◽  
...  

(1) Background and Aim: Despite excellent long-term results in pediatric liver transplantation (pLTx), mortality and graft loss still are to be diminished. We aim to describe time-dependent changes and long-term outcome of a large single-center pLTx cohort and to identify independent recipient-related risk factors impairing patient and graft survival. (2) Methods: This is a retrospective single-center study analyzing all pediatric liver transplants from 1983–2020. Risk factors for mortality and graft loss were identified by univariable and multi-linear regression analysis. (3) Results: We analyzed 858 liver transplantations in 705 pediatric patients. Five-year patient/graft survival increased from 60.9%/48.0% (1983–1992) to 97.5%/86.5% (OR = 12.5; p < 0.0001/OR = 6.5; p < 0.0001) (2014–2020). Indications changed significantly over time, with a higher proportion of patients being transplanted for malignancies and metabolic disease and indications of PFIC and α1AT-deficiency declining. The era of transplantation (log7.378/9.657; p < 0.0001) and indication of acute liver failure (log = 1.944/2.667; HR = 2.015/1.772; p = 0.0114/0.002) impairs patient/graft survival significantly in the multivariate analysis. Furthermore, patient survival is worsened by re-transplantation (log = 1.755; HR = 1.744; p = 0.0176) and prolonged waiting times in high-urgency status (log = 2.588; HR = 1.073; p = 0.0026), whereas the indication of biliary atresia improved outcome (log = 1.502; HR = 0.575; p = 0.0315). Graft survival was additionally impaired by pre-existing portal vein thrombosis (log = 1.482; HR = 2.016; p = 0.0330). (4) Conclusions: Despite more complex indications, patient and graft survival after pLTx continue to improve.. Acute liver failure remains the indication with poorest outcome, and listing for high urgency liver transplantation should be considered carefully and early to keep waiting time on HU list short. Furthermore, pre-transplant portal vein thrombosis should be prevented whenever possible to improve graft survival.


2006 ◽  
Vol 12 (5) ◽  
pp. 718-725 ◽  
Author(s):  
Ivo W. Graziadei ◽  
Hubert Schwaighofer ◽  
Robert Koch ◽  
Karin Nachbaur ◽  
Alfred Koenigsrainer ◽  
...  

2018 ◽  
Vol 87 (6) ◽  
pp. AB227
Author(s):  
Carlos A. Macías Gomez ◽  
Federico H. Marcaccio ◽  
Victoria Ardiles ◽  
Santiago Rinaudo ◽  
Martin de Santibañes ◽  
...  

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