Biliary Strictures After Liver Transplantation: Risk Factors and Prevention by Donor Treatment With Epoprostenol

Pirenne, Jacques; Monbaliu, Diethard; Aerts, Raymond; Desschans, Bruno; Liu, Q.; Cassiman, David; Laleman, Wim; Verslype, Chris; Magdy, Mark; Steenbergen, Werner Van; Nevens, Frederik

doi:10.1016/j.transproceed.2009.09.026

Cited by 36 publications

(40 citation statements)

References 9 publications

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“…It was reported that the incidence of biliary strictures in patients who have undergone LDLT with duct-to-duct biliary reconstruction is less than 30% [10,15,16]. The virtually decreased incidence of strictures in LDLT compared with those in BDI suggests that they are not simply "technical" in origin, but probably represent a mucosa ischemic injury inherent in the operative procedure or other mechanisms [17,18]. Various refinements in surgical techniques, postoperative management, and immunosuppressive management have reduced the incidence of strictures after liver transplantation [3,19].…”

Section: Discussionmentioning

confidence: 99%

Development of an animal model for assessment of primary end-to-end biliary reconstruction

Tian

Zhang

et al. 2012

Eur Surg

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Section: Discussionmentioning

confidence: 99%

Development of an animal model for assessment of primary end-to-end biliary reconstruction

Tian

Zhang

et al. 2012

Eur Surg

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“…388 The incidence of nonanastomotic BS has been reduced through the use of low-viscosity preservation fluids, fluid pressurisation, and the addition of urokinase to the preservation solution in the hepatic artery. 389,390 However, a recent retrospective study has shown that flushing the liver with urokinase immediately before implantation did not lead to a lower incidence of nonanastomotic BS. 391 Data from the European Liver Transplant Registry suggest that the University of Wisconsin, Celsior and Institut Georges Lopez-1 preservation solutions perform better than histidinetryptophan-ketoglutarate (HTK) solution, the latter being associated with a 10% increase in the risk of graft loss.…”

Section: Donor Managementmentioning

confidence: 99%

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

et al. 2017

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Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes. COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant. The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting. 12 Department of Gastroenterology and Hepatology, Erasmus MC, University Hospital Rotterdam, the Netherlands. 13 Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium.14 Abdominal Transplant Surgery, Microbiology and Immunology Department, University Hospitals KU Leuven, Belgium. 15 Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Spain. www.transplantjournal.com S1 S olid organ transplantation has evolved from an experimental procedure to an established treatment option for many types of end-stage organ failure. Both patient and graft outcomes are continuing to improve, and 1-year patient and graft survival currently exceed 80%.1,2 However, survival rates gradually decline over the long term. In kidney transplant, 5-and 10-year graft survival rates in Europe are 77% and 56%, and for liver transplant, 64% and 54% (Figures 1 and 2). 3,4 Although most European countries have seen an increase in both living and deceased donation, transplantation is not available to all who would benefit from the procedure, and there is considerable morbidity and mortality for those listed for transplant.6 Therefore, maximizing long-term graft survival and reducing the need for retransplantation is paramount, not only in improving outcomes for the recipients but also for those awaiting a graft. The improvement in outcomes is predominantly due to reduction in (Transplantation. 2017;101:S1-S41). The authors were approached by Astellas to discuss the practical implementation o...

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“…131 The incidence of BS has been reduced through the use of low-viscosity preservation fluids, fluid pressurization, and the addition of urokinase to the preservation solution and in the hepatic artery. [132][133][134] Data from the ELTR suggest that the University of Wisconsin, Celsior and IGL-I preservation solutions perform better than HTK, the latter being associated with a 10% increase in the risk of graft loss. 135 In animal models, the addition of trophic factors to preservation solutions improves organ function immediately posttransplant.…”

Section: Early Allograft Dysfunction and Biliary Strictures After LIVmentioning

confidence: 99%

Advancing Transplantation

et al. 2017

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Biliary Strictures After Liver Transplantation: Risk Factors and Prevention by Donor Treatment With Epoprostenol

Cited by 36 publications

References 9 publications

Development of an animal model for assessment of primary end-to-end biliary reconstruction

Development of an animal model for assessment of primary end-to-end biliary reconstruction

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

Advancing Transplantation

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