Cholangiographic findings in hepatic artery occlusion after liver transplantation

Zajko, Albert B.; Campbell, William L.; Logsdon, Gregory; Bron, Klaus M.; Tzakis, Andreas G.; Esquivel, Carlos O.; Starzl, Thomas E.

doi:10.2214/ajr.149.3.485

Cited by 166 publications

(80 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To not confound recurrence of PSC with nonanastomotic strictures because of other causes, patients with hepatic artery thrombosis/stenosis and chronic ductopenic rejection, conditions well known to be associated with the development of nonanasto- motic strictures, were excluded. [21][22][23][24] In addition, we excluded those patients who developed nonanastomotic strictures within the first 90 days posttransplantation to avoid tainting of the study group with patients having ischemic biliary damage as a result of ischemia/reperfusion-induced injury. 20,25 In a previous article, we showed that ischemic-type biliary strictures occurred at a mean of 82 days following liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

Recurrence of Primary Sclerosing Cholangitis Following Liver Transplantation

et al. 1999

View full text Add to dashboard Cite

Recurrence of primary sclerosing cholangitis (PSC) following liver transplantation has been suggested; however, it has not been fully defined because of numerous complicating factors and the lack of diagnostic criteria. In the present study, we investigated the recurrence of PSC by developing strict criteria and applying them to a large cohort of PSC patients who underwent liver transplantation. Between March 1985 and June 1996, 150 PSC patients underwent liver transplantation at the Mayo Clinic; mean follow up was 55 months. The incidence of nonanastomotic biliary strictures and hepatic histologic findings suggestive of PSC were compared between patients transplanted for PSC and a non-PSC transplant control group. Our definition of recurrent PSC was based on characteristic cholangiographic and histologic findings that occur in nontransplant PSC patients. By using strict criteria, 30 patients with other known causes of posttransplant nonanastomotic biliary strictures were excluded leaving 120 patients for analysis of recurrence of PSC. We found evidence of PSC recurrence after liver transplantation in 24 patients (20%). Of these, 22 out of 24 patients showed characteristic features of PSC on cholangiography and 11 out of 24 had compatible hepatic histologic abnormalities with a mean time to diagnosis of 360 and 1,350 days, respectively. Both cholangiographic and hepatic histologic findings suggestive of PSC recurrence were seen in nine patients. The higher incidence and later onset of nonanastomotic biliary strictures in patients with PSC compared with a non-PSC control group is supportive of the fact that PSC does recur following liver transplantation. We were unable to identify specific clinical risk factors for recurrent PSC, and the overall patient and graft survival in patients with recurrent PSC was similar to those without evidence of recurrence. Our observations provide convincing evidence that PSC frequently recurs in the hepatic allograft using strict inclusion and exclusion criteria. (HEPATOLOGY

show abstract

Section: Discussionmentioning

confidence: 99%

Recurrence of Primary Sclerosing Cholangitis Following Liver Transplantation

et al. 1999

View full text Add to dashboard Cite

show abstract

“…biliary tree [23][24][25] secondary to arterial occlusion or as a consequence of biliary injury from prolonged cold preservation. Ischemic times in excess of 12 hours significantly increase the risk for intrahepatic biliary strictures.…”

Section: S48mentioning

confidence: 99%

Management of biliary problems after liver transplantation

Möser

Wall

2001

Liver Transplantation

110

View full text Add to dashboard Cite

“…Biliary stricture is often referred to as anastomotic or nonanastomotic, and nonanastomotic biliary stricture is generally thought to be the most troublesome type of biliary complication. 1 The mostcommon causes of nonanastomotic biliary stricture are related to hepatic artery thrombosis, 7 and nonanastomotic biliary stricture without hepatic artery thrombosis is rare. 3,8 Although the pathogenesis of nonanastomotic biliary stricture is likely multifactorial, several studies have strongly suggested a critical role for ischemic injury of the peribiliary vascular plexus.…”

Section: Discussionmentioning

confidence: 99%

“…The reported incidence of nonanastomotic biliary stricture varies greatly between different series, ranging from 1.4% to 19.0%. [2][3][4][5][6] The most common causes of nonanastomotic biliary stricture are related to hepatic artery thrombosis 7 ; nonanastomotic biliary stricture without hepatic artery thrombosis is rare. 3,8 Other identified causes include (1) ischemic injury (such as prolonged cold or warm ischemia time), 9 severe reperfusion injury, 10 or deceaseddonor LT 11 ; (2) immunologic injury such as chronic rejection, 12 ABO incompatibility, 13 cytomegalovirus infection, 14 or recurrence of primary disease (primary sclerosing cholangitis or autoimmune hepatitis) 15 ; and (3) bile-salt-induced injury.…”

Section: Abstract: Nonanastomotic Biliary Stricture Acute Cellular mentioning

confidence: 99%

Co-occurrence of Nonanastomotic Biliary Stricture and Acute Cellular Rejection in Liver Transplant

Sanada¹,

Mizuta²,

Urahashi³

et al. 2012

Exp Clin Transplant

View full text Add to dashboard Cite

Background: Nonanastomotic biliary stricture is generally considered the most troublesome biliary complication after liver transplant. Nonanastomotic biliary stricture owing to immunologic cholangiopathy (such as acute cellular rejection) has not been reported. We describe 2 patients with the co-occurrence of nonanastomotic biliary stricture and acute cellular rejection after pediatric live-donor liver transplant. Case 1: A 13-month-old male infant with liver cirrhosis underwent an ABO-identical live-donor liver transplant using a left lateral segment graft. Eighty days after the live-donor liver transplant, fever with liver dysfunction and dilatation of the intrahepatic bile duct occurred. Percutaneous transhepatic biliary drainage and a liver biopsy were performed. The histopathologic evaluation indicated the presence of acute cellular rejection. After percutaneous transhepatic biliary drainage and steroid pulse treatment, the patient showed good clinical outcome. Case 2: A 21-month-old female infant with biliary atresia underwent an ABO-identical live-donor liver transplant using a left lateral segment graft. Twenty-six days after the live-donor liver transplant, percutaneous transhepatic biliary drainage for B3 and a liver biopsy were performed, owing to fever, with liver dysfunction, and dilatation of the intrahepatic bile duct. Histopathologic evaluation indicated the presence

show abstract

Cholangiographic findings in hepatic artery occlusion after liver transplantation

Cited by 166 publications

References 14 publications

Recurrence of Primary Sclerosing Cholangitis Following Liver Transplantation

Recurrence of Primary Sclerosing Cholangitis Following Liver Transplantation

Management of biliary problems after liver transplantation

Co-occurrence of Nonanastomotic Biliary Stricture and Acute Cellular Rejection in Liver Transplant

Contact Info

Product

Resources

About