Endoscopic Management of Biliary Complications following Liver Transplantation after Donation from Cardiac Death Donors

BACKGROUND Previous studies have shown a higher incidence of biliary complications following donation after cardiac death (DCD) liver transplantation compared with donation after brain death (DBD) liver transplantation. The endoscopic management of ischemic type biliary strictures in patients who have undergone DCD liver transplants needs to be characterized further.METHODS: A retrospective institutional review of all patients who underwent DCD liver transplant from January 2006 to September 2011 was performed. These patients were compared with all patients who underwent DBD liver transplantation in the same time period. A descriptive analysis of all DCD patients who developed biliary complications and their subsequent endoscopic management was also performed.RESULTS: Of the 36 patients who received DCD liver transplants, 25% developed biliary complications compared with 13% of patients who received DBD liver transplants (P=0.062). All DCD allograft recipients who developed biliary complications became symptomatic within three months of transplantation. Ischemic type biliary strictures in DCD allograft recipients included disseminated biliary strictures in two patients, biliary strictures of the hepatic duct bifurcation in three patients and biliary strictures of the donor common hepatic duct in three patients.CONCLUSIONS: There was a trend toward increasing incidence of total biliary complications in recipients of DCD liver allografts compared with those receiving DBD livers, and the rate of diffuse ischemic cholangiopathy was significantly higher. Focal ischemic type biliary strictures can be treated effectively in DCD liver transplant recipients with favourable results. Diffuse ischemic type biliary strictures in DCD liver transplant recipients ultimately requires retransplantation.

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Endoscopic management of biliary strictures in liver transplant recipients: effect on patient and graft survival

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(98)70344-x ◽

1998 ◽

Vol 47 (2) ◽

pp. 128-135 ◽

Cited By ~ 105

Author(s):

Rafat S. Rizk ◽

John P. McVicar ◽

Mary J. Emond ◽

Charles A. Rohrmann ◽

Kris V. Kowdley ◽

...

Keyword(s):

Liver Transplant ◽

Graft Survival ◽

Endoscopic Management ◽

Transplant Recipients ◽

Biliary Strictures ◽

Liver Transplant Recipients ◽

Patient And Graft Survival

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Management of COVID-19 in Liver Transplant Recipients with Immunosuppressant Therapy: Experiences of an Iranian Transplant Registry

10.21203/rs.3.rs-62369/v1 ◽

2020 ◽

Author(s):

Zahra Sheikhalipour ◽

Touraj Asvadi kermani ◽

Farzad Kakaei ◽

Azizeh Farshbaf Khalili ◽

Leila Vahedi

Keyword(s):

Liver Transplantation ◽

Liver Transplant ◽

Organ Transplant ◽

Immunosuppressive Drugs ◽

Personal Hygiene ◽

Transplant Recipients ◽

Liver Transplants ◽

Transplant Registry ◽

Use Of Medical Services ◽

Liver Transplant Recipients

Abstract Background: Following the pandemic of COVID-19 and the increased COVID-19 risk in transplant patient receptions, the authors assessed the prevalence, clinical course, and the outcome of the COVID-19 infection among liver transplant receptions. Methods: By designing and the use of researcher made questionnaire and the use of medical services, liver transplantation recipients under our center surveyed in terms of COVID-19 infection.Results: Seven patients infected with COVID-19 were identified from 265 liver transplantation recipients. The majority of patients were male and had COVID-19 despite being in-home quarantine. All patients received immunosuppressive drugs during infection with COVID-19 with no change in the routine immunosuppressive therapy. Among the identified patients, 5 recovered and 2 died. One of the dead patients, in addition to having a liver transplant, suffered brain cancer with metastasis to the lungs. Conclusion: It seems that the in liver transplants infected with COVID-19, the immunosuppressive drugs causes mild to moderate illness, and even recover from the disease.However, more evidence is needed to prove this hypothesis. It is also recommended that transplant recipients should be warned about personal hygiene and closely be monitored by organ transplant centers.

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The value of percutaneous transhepatic treatment of biliary strictures following pediatric liver transplantation

Radiologia Brasileira ◽

10.1590/0100-3984.2016.0087 ◽

2017 ◽

Vol 50 (5) ◽

pp. 308-313 ◽

Cited By ~ 11

Author(s):

Leandro Cardarelli-Leite ◽

Vinicius Adami Vayego Fornazari ◽

Rogério Renato Peres ◽

Alcides Augusto Salzedas-Neto ◽

Adriano Miziara Gonzalez ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Transplant ◽

Clinical Success ◽

Transplant Recipients ◽

Biliary Strictures ◽

Pediatric Liver ◽

Drain Removal ◽

The Mean ◽

Liver Transplant Recipients ◽

Pediatric Liver Transplant

Abstract Objective: To evaluate the percutaneous transhepatic approach to the treatment of biliary strictures in pediatric patients undergoing liver transplantation. Materials and Methods: This was a retrospective study of data obtained from the medical records, laboratory reports, and imaging examination reports of pediatric liver transplant recipients who underwent percutaneous transhepatic cholangiography, because of clinical suspicion of biliary strictures, between 1st September 2012 and 31 May 2015. Data were collected for 12 patients, 7 of whom were found to have biliary strictures. Results: In the 7 patients with biliary strictures, a total of 21 procedures were carried out: 2 patients (28.6%) underwent the procedure twice; 3 (42.8%) underwent the procedure three times; and 2 (28.6%) underwent the procedure four times. Therefore, the mean number of procedures per patient was 3 (range, 2–4), and the average interval between them was 2.9 months (range, 0.8–9.1 months). The drainage tube remained in place for a mean of 5.8 months (range, 3.1–12.6 months). One patient presented with a major complication, hemobilia, which was treated with endovascular embolization. Clinical success was achieved in all 7 patients, and the mean follow-up after drain removal was 15.4 months (range, 5.3–26.7 months). Conclusion: The percutaneous transhepatic approach to treating biliary strictures in pediatric liver transplant recipients proved safe, with high rates of technical and clinical success, as well as a low rate of complications.

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Endoscopic Management of Biliary Complications in Liver Transplant Recipients

The American Journal of Gastroenterology ◽

10.14309/00000434-201210001-01914 ◽

2012 ◽

Vol 107 ◽

pp. S779-S780

Author(s):

Rohini Vanga ◽

Mohamed Hassan ◽

Muhammad Farrukh Shezad ◽

Thomas Fishbein ◽

Kirti Shetty ◽

...

Keyword(s):

Liver Transplant ◽

Biliary Complications ◽

Endoscopic Management ◽

Transplant Recipients ◽

Liver Transplant Recipients

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Su1424 UNPLANNED ERCP FOR BILIARY COMPLICATIONS IS MORE COMMONLY PERFORMED IN LIVING DONOR LIVER TRANSPLANT RECIPIENTS COMPARED TO DONATION AFTER BRAIN OR CARDIAC DEATH RECIPIENTS

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2020.03.2190 ◽

2020 ◽

Vol 91 (6) ◽

pp. AB339-AB340

Author(s):

Jasmine Sinha ◽

Arnold Abud ◽

Rajesh N. Keswani ◽

Sri Komanduri ◽

A. Aziz Aadam

Keyword(s):

Liver Transplant ◽

Cardiac Death ◽

Living Donor ◽

Biliary Complications ◽

Transplant Recipients ◽

Donor Liver ◽

Living Donor Liver Transplant ◽

Donor Liver Transplant ◽

Liver Transplant Recipients

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4674 Endoscopic management of biliary complications in 369 liver transplant recipients.

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(00)14521-3 ◽

2000 ◽

Vol 51 (4) ◽

pp. AB200

Author(s):

Shea O. Ross ◽

Stephen T. Amann ◽

Christopher E. Forsmark

Keyword(s):

Liver Transplant ◽

Biliary Complications ◽

Endoscopic Management ◽

Transplant Recipients ◽

Liver Transplant Recipients

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Peritoneal Dialysis After Liver Transplantation: A Systematic Review

Canadian Journal of Kidney Health and Disease ◽

10.1177/20543581211029722 ◽

2021 ◽

Vol 8 ◽

pp. 205435812110297

Author(s):

Jean Maxime Côté ◽

Isabelle Ethier ◽

Héloïse Cardinal ◽

Marie-Noëlle Pépin

Keyword(s):

Systematic Review ◽

Liver Transplantation ◽

Liver Transplant ◽

Kidney Failure ◽

Liver Graft ◽

Transplant Recipients ◽

Technique Survival ◽

Liver Transplant Recipients

Background: Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear. Objective: To determine the feasibility regarding safety, technique survival, and dialysis efficiency of PD in liver transplant recipients requiring KRT for maintenance dialysis. Design: Systematic review. Setting: Interventional and observational studies reporting the use of PD after liver transplantation. Patients: Adult liver transplant recipients with kidney failure treated with maintenance KRT. Measurements: Extracted data included eligibility criteria, study design, demographics, and PD modality. The following outcomes of interest were extracted: rate of peritonitis and microorganisms involved, noninfectious peritoneal complications, technique survival, and kidney transplantation-censored technique survival. Non-PD complications included overall survival, liver graft dysfunction, and hospitalization rate. Methods: The following databases were searched until July 2020: MedLine/PubMed, EMBASE, CINAHL, and Cochrane Library. Two reviewers independently screening all titles and abstracts of all identified articles. Due to the limited sample size, observational designs and study heterogeneity expected, no meta-analysis was pre-planned. Descriptive statistics were used to report all results. Results: From the 5263 identified studies, 4 were included in the analysis as they reported at least 1 outcome of interest on a total of 21 liver transplant recipients, with an overall follow-up duration on PD of 19.0 (Interquartile range [IQR]: 9.5-29.5) months. Fifteen episodes of peritonitis occurred in a total cumulative PD follow-up of 514 patient-months, representing an incidence rate of 0.35 per year. These episodes did not result in PD technique failure, mortality, or impairment of liver graft function. Limitations: Limitations include the paucity of studies in the field and the small number of patients included in each report, a risk of publication bias and the impossibility to directly compare hemodialysis to PD in this population. These results, therefore, must be interpreted with caution. Conclusions: Based on limited data reporting the feasibility of PD in liver transplant recipients with kidney failure, no signal was associated with an increased risk of infectious complications. Long-term studies evaluating this modality need to be performed. Registration (PROSPERO): CRD42020218374.

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Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽

10.1093/qjmed/hcaa052.005 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M G Abdelrahman ◽

H A Mahmoud ◽

M K Mohsen ◽

M O Ali ◽

A M N Mohamed

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Liver Transplant ◽

Organ Transplantation ◽

Chronic Rejection ◽

Cytomegalovirus Infection ◽

Transplant Recipients ◽

Cmv Infection ◽

Donor Liver Transplantation ◽

Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

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