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

Rizk, Rafat; McVicar, John P.; Emond, Mary J.; Rohrmann, Charles A.; Kowdley, Kris V.; Perkins, James D.; Carithers, Robert L.; Kimmey, Michael B.

doi:10.1016/s0016-5107(98)70344-x

Cited by 145 publications

(131 citation statements)

References 23 publications

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“…Intrahepatic strictures are more difficult to treat and require more frequent ERCP, and success rates only approximate 25% with prolonged follow-up. 35 Nonsurgical intervention, at least initially, seems to be warranted in the management of these strictures or as a temporizing method until the patient is better able to withstand surgical intervention.…”

Section: Nonanastomotic Stricturesmentioning

confidence: 99%

Management of biliary problems after liver transplantation

Möser

Wall

2001

Liver Transplantation

110

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Section: Nonanastomotic Stricturesmentioning

confidence: 99%

Management of biliary problems after liver transplantation

Möser

Wall

2001

Liver Transplantation

110

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“…6) [2,10,25]. In most cases the treatment of strictures is performed conservatively by endoscopic or transhepatic dilatation [24,33,40]. Supportive measures should comprise antibiotic prophylaxis and treatment with ursodesoxycholic acid [2].…”

Section: Therapymentioning

confidence: 99%

“…Most of the ITBL-patients are currently treated by the endoscopic or percutaneous placement of stents and balloon dilatation [32,33,40]. However, significantly different success rates are observed depending upon the localization and occurrence of the strictures.…”

Section: Endoscopic and Transhepatic Treatmentmentioning

confidence: 99%

“…Therefore, the relatively high chance of misclassification regarding patient cohorts undergoing statistical analysis of etiologic risk factors including epidemiologic aspects may explain differences in ITBL-incidence reported in the literature [10,74]. After the exclusion of PSC-patients and managed post-transplant vascular complications the incidence of ITBL is supposed to be much lower than 20% [27,40,47,75]. Recent analysis performed in a homogenous cohort after the exclusion of patients with prolonged re-arterialization and PSC-recurrence, seems to reflect the incidence of ITBL (3.9%) most accurately [1].…”

Section: Conclusion and Future Prospectivementioning

confidence: 99%

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Ischemic Type Biliary Lesions

Eurich¹,

Seehofer²,

Neuhaus³

2012

Liver Transplantation - Technical Issues and Complications

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“…These strictures are often treated with endoscopic or percutaneous balloon dilatation and/or stenting. [26][27][28] However, approximately 20% of such nonanastomotic strictures are refractory or untreatable using endoscopic or percutaneous therapy because they involve the small intrahepatic bile ducts. In these situations, retransplantation may be necessary.…”

Section: S64mentioning

confidence: 99%

Late hepatic allograft dysfunction

Wiesner

2001

Liver Transplantation

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Key Points1. Lifelong monitoring of graft function, immunosuppressive levels, and screening for drug toxicity is required in all liver recipients.2. Late hepatic allograft dysfunction is common and is caused by a variety of etiologies including rejection, infection, biliary/vascular abnormalities, recurrence of disease, and drug hepatotoxicity.3. In all patients with late hepatic allograft dysfunction, liver biopsy should be performed to assess for the presence of rejection, and to thus avoid excessive use of bolus corticosteroid therapy and guide appropriate immunosuppressive management.4. Recurrence of disease is the most common cause of late hepatic allograft dysfunction.5. Hepatitis C universally reinfects the hepatic allograft, and is associated with decreased patient and graft survival and leads to the recurrence of cirrhosis in 28% of patients within 5 years of transplantation.

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

Cited by 145 publications

References 23 publications

Management of biliary problems after liver transplantation

Management of biliary problems after liver transplantation

Ischemic Type Biliary Lesions

Late hepatic allograft dysfunction

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