Incidencia, factores de riesgo y tratamiento de las complicaciones biliares del trasplante hepático

N, Mauricio Gabrielli; M, Enrique Norero; R, Eduardo Figueroa; G, Pablo Cortés; M, Fernando Pimentel; G, Álvaro Huete; Q, Luis Meneses; Z, Soledad Loyola; J, Marco Arrese; R, Alejandro Soza; A, Rosa María Pérez; B, Pilar Domínguez; C, Juan Francisco Guerra; C, Nicolás Jarufe; C, Jorge Martínez

doi:10.4067/s0718-40262010000400006

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…Las complicaciones biliares aún constituyen una fuente de morbilidad del TH, presentándose en globo en 30,6% de nuestros TH en adultos (18% de estenosis de anastómosis biliar) 16,47,48 . Aunque su frecuencia no ha logrado reducirse en el tiempo 14,49 , su pesquisa y mejor tratamiento han permitido que no se traduzca en una mayor mortalidad peri-operatoria.…”

Section: Discussionunclassified

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Trasplante hepático: evolución, curva de aprendizaje y resultados después de los primeros 300 casos

et al. 2019

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Liver transplantation: development, learningcurve and results after the first 300 cases Background: Liver transplantation (LT) is an option for people with liver failure who cannot be cured with other therapies and for some people with liver cancer. Aim: To describe, and analyze the first 300 LT clinical results, and to establish our learning curve. Material and Methods: Retrospective cohort study with data obtained from a prospectively collected LT Program database. We included all LT performed at a single center from March 1994 to September 2017. The database gathered demographics, diagnosis, indications for LT, surgical aspects and postoperative courses. We constructed a cumulative summation test for learning curve (LC-CUSUM) using 30-day post-LT mortality. Mortality at 30 days, and actuarial 1-, and 5-year survival rate were analyzed. Results: A total of 281 patients aged 54 (0-71) years (129 women) underwent 300 LT. Ten percent of patients were younger than 18 years old. The first, second and third indications for LT were non-alcoholic steatohepatitis, chronic autoimmune hepatitis and alcoholic liver cirrhosis, respectively. Acute liver failure was the LT indication in 51 cases (17%). The overall complication rate was 71%. Infectious and biliary complications were the most common of them (47 and 31% respectively). The LC-CUSUM curve shows that the first 30 patients corresponded to the learning curve. The peri-operative mortality was 8%. Actuarial 1 and 5-year survival rates were 82 and 71.4%, respectively. Conclusions: Outcome improvement of a LT program depends on the accumulation of experience after the first 30 transplants and the peri-operative mortality directly impacted long-term survival. (Rev Med Chile 2019; 147: 955-964)

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Section: Discussionunclassified

“…Complementando publicaciones nacionales previas 10,[13][14][15][16][17] , el objetivo de este trabajo es describir la evolución de nuestro programa, analizar sus resultados y establecer la curva de aprendizaje de los primeros 300 TH realizados en nuestra institución.…”

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Trasplante hepático: evolución, curva de aprendizaje y resultados después de los primeros 300 casos

et al. 2019

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“…1,6,10 They result in a high morbidity rate, and occasionally result in graft loss, with a mortality rate of up to 30% despite recent advances in surgical techniques. [10][11][12][13] Living-donor liver transplantation is the most frequent liver transplant in our institution. In these patients, bile duct anastomosis is performed on small ducts that results in a higher rate of biliary complications (34%) as compared with cadaveric donor transplantation (14%).…”

Section: Introductionmentioning

confidence: 99%

“…1 6 10 They result in a high morbidity rate, and occasionally result in graft loss, with a mortality rate of up to 30% despite recent advances in surgical techniques. 10 11 12 13…”

Section: Introductionmentioning

confidence: 99%

Hepatobiliary Scintigraphy to Evaluate Biliary Complications of Pediatric Liver Transplantation: An Account of an Experience

et al. 2020

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Introduction Hepatobiliary scintigraphy (HS) is a noninvasive imaging technique whose use in the follow-up of liver transplantation has not been duly documented. The main objective of this study is to describe the experience of using this technique to detect biliary complications in pediatric patients following liver transplantation. Materials and Methods A retrospective, observational, and descriptive study involving 86 pediatric patients who had undergone liver transplantation between 2013 and 2018. Of the 86, 31 had undergone at least one HS during their postoperative period. Results A total of 45 studies were performed on 31 patients (36% of the patients undergoing transplantation during that time period). Patient ages ranged from 5 to 204 months (mean = 50 months). A total of 22 transplants (71%) were from living donors and 9 (29%) were from cadaveric donors. Of the 45 studies, 22 were positive for biliary complications, and all of them had an impact on clinical decision-making. The remaining 23 studies were negative. Of these 23, 19 continued under medical treatment and the other four underwent an additional intervention with positive surgical outcomes in all cases. All scintigraphy studies revealed hepatocellular dysfunction and cholestasis. Conclusion The HS is a useful, noninvasive, and diagnostic procedure for the early diagnosis of biliary complications that may impact the evolution of disease in liver transplant patients. It allows the treating physician to make a more informed decision regarding expectant management, surgical management, or a less invasive course of action for transplantation complications.

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Gammagrafía hepatobiliar en el estudio de las complicaciones del trasplante hepático en adultos. Descripción de la experiencia

Vélez-Gutierrez

Gutiérrez-Villamil

Arevalo-Leal

et al. 2019

Revista Española de Medicina Nuclear e Imagen Molecular

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Incidencia, factores de riesgo y tratamiento de las complicaciones biliares del trasplante hepático

Cited by 4 publications

References 6 publications

Trasplante hepático: evolución, curva de aprendizaje y resultados después de los primeros 300 casos

Trasplante hepático: evolución, curva de aprendizaje y resultados después de los primeros 300 casos

Hepatobiliary Scintigraphy to Evaluate Biliary Complications of Pediatric Liver Transplantation: An Account of an Experience

Gammagrafía hepatobiliar en el estudio de las complicaciones del trasplante hepático en adultos. Descripción de la experiencia

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