Impact of biliary complications on quality of life in live-donor liver transplant recipients

Guirguis, Reginia Nabil; Nashaat, Ehab H.; Yassin, Azza Emam; Ibrahim, Wesam A.; Saleh, Shereen A.; Bahaa, Mohamed; El-Meteini, Mahmoud; Fathy, Mohamed; Dabbous, Hany; Montasser, Iman Fawzy; Salah, Maged; Mohamed, Ghada

doi:10.4254/wjh.v13.i10.1405

Cited by 4 publications

(3 citation statements)

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“…HA thrombosis (HAT) is a severe complication after liver transplantation, associated with biliary complications such as ischemic cholangiopathy, which may occur even after a successful revascularization treatment, resulting in late graft loss and therefore having a critical impact on quality of life[ 12 , 13 ]. Furthermore, HAT is considered as a risk factor for deve lopment of biliary stones in liver graft, which is associated with recurring cholangitis, secondary biliary cirrhosis, and graft failure[ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Improving the radiological diagnosis of hepatic artery thrombosis after liver transplantation: Current approaches and future challenges

Lindner,

Riquelme,

San Martín

et al. 2024

World J Transplant

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Hepatic artery thrombosis (HAT) is a devastating vascular complication following liver transplantation, requiring prompt diagnosis and rapid revascularization treatment to prevent graft loss. At present, imaging modalities such as ultrasound, computed tomography, and magnetic resonance play crucial roles in diagnosing HAT. Although imaging techniques have improved sensitivity and specificity for HAT diagnosis, they have limitations that hinder the timely diagnosis of this complication. In this sense, the emergence of artificial intelligence (AI) presents a transformative opportunity to address these diagnostic limitations. The development of machine learning algorithms and deep neural networks has demonstrated the potential to enhance the precision diagnosis of liver transplant complications, enabling quicker and more accurate detection of HAT. This article examines the current landscape of imaging diagnostic techniques for HAT and explores the emerging role of AI in addressing future challenges in the diagnosis of HAT after liver transplant.

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Section: Introductionmentioning

confidence: 99%

Improving the radiological diagnosis of hepatic artery thrombosis after liver transplantation: Current approaches and future challenges

Lindner,

Riquelme,

San Martín

et al. 2024

World J Transplant

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“…A major factor that adds to the difficulty of liver transplant is the need to allocate the scarce donated livers to the increasing number of patients in need of and likely to benefit from this procedure -the recently included groups of acute alcoholic hepatitis, intrahepatic cholangiocarcinoma, and colorectal metastasis patients [2], as well as the previously included groups of patients with decompensated cirrhosis due to hepatitis B, hepatitis C, autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis [3]. Other factors that contribute to the complicated nature of liver transplantation include the need for lifelong immunotherapy [4], and the associated surgical and medical complications [5][6][7][8]. With the continual rise of cirrhosis worldwide [9], the demand for liver transplants is expected to rise, as will the need to address all associated factors and complications.…”

Section: Introductionmentioning

confidence: 99%

Emergency Department Frequentation and Unscheduled Visits of Liver Transplant Patients: Ten Years Experience in Tertiary Care Center, Saudi Arabia

Aljumaa,

AlShathri,

Aljumaa

et al. 2023

Cureus

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Introduction and objectives Liver transplantation and its indications represent an increased burden on patients' health. This can be represented in a variety of ways, such as in emergency visits, unscheduled clinic visits, and unanticipated admissions. This study aims to analyze emergency department (ED) visits, the most common presenting complaints, and the outcomes of those visits. Methods A retrospective observational study was performed in which electronic medical records were reviewed for all patients who underwent liver transplantation and presented to the emergency department between October 2011 and October 2021. The following data were collected: demographics, comorbidities, liver transplant features, and emergency department visit data and outcomes. Recurrent visits were assessed and labeled as first, second, third, fourth, and fifth or more. Results A total of 699 patients and 5,225 visits were included in the analysis. Living donors accounted for 80% of all transplants. The mean post-operative length of stay was 22.6 ± 17.8. The majority of patients (74%) had at least one comorbidity, with diabetes (47%), hypertension (31%), and chronic kidney disease (CKD) (16%) being the commonest comorbidities; however, comorbidities were not associated with an increased risk of emergency department visits. Out of the 5,225 visits to the emergency department, 2,265 (41%) were within the first year. Emergency department visits in the first seven days after discharge amounted to 22% of total first visits. By 30 days, six months, and one year, they increased to 46%, 83%, and 91%, respectively. Living donor recipients had an average of 7.3 ED visits as compared to deceased donor recipients, who had an average of 8.4 ED visits. The most common presenting complaints were gastrointestinal (GI) symptoms (18%), infectious disease symptoms (9%), and respiratory symptoms (8%). There were a total of 296 patients who were readmitted at least once since discharge after liver transplantation. Conclusion The majority of first-time presentations to ED occurred in the first year post-transplant, marking this time period as critical for liver transplant patients. Our study also highlighted the continual presentations of liver transplant patients to the ED a few years post-transplant. This requires close scrutiny of the main causes of such presentations as well as comparison with other transplant cases to identify whether they are specific to liver transplants or not.

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“…Biliary complications in LDLT lead to a lower range of improvement in health-related quality of life compared to recipients with no biliary complications ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Risk factors and management of biliary stones after living donor liver transplant and its effect on graft outcome

et al. 2022

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BackgroundBile stones are associated with numerous complications in liver transplant recipients. Endoscopic retrograde cholangiopancreatography (ERCP) has been proven to be safe and highly effective in dealing with most post-transplant biliary complications.ObjectiveThe objective of this study was to identify the possible risk factors for bile stone formation on top of biliary stricture, the effects of stones on graft outcomes, and their management.MethodsThis case–control study included 83 patients who underwent living donor liver transplant (LDLT) and suffered from postoperative biliary stricture with or without stones. Patients were divided into two groups. Group 1 (n = 55) included patients with biliary strictures with no stones and group 2 (n = 28) included patients who developed stones on top of biliary strictures. Data about the recipient and donor characteristics, surgical technique, blood lipid profile, immunosuppressive drugs, post-transplant complications, and interventions were collected from the medical records.ResultsThe frequency of hepatitis C virus (HCV) was significantly higher in group 2 compared to group 1 (71.4% vs. 47.3%, p = 0.036). The body mass index (BMI) of the donors was significantly higher in group 2 than in group 1 (25.17 ± 2.53 vs. 23.68 ± 2.63, p = 0.015). Episodes of acute rejection were significantly higher in group 2 than in group 1 (21.4% vs. 5.5%, p = 0.027). The ERCP was sufficient in most of the cases (89.2%) to ensure biliary drainage. The identified independent risk factors for biliary stones included HCV, biliary drain, donor's BMI, and serum cholesterol level.ConclusionPositive HCV, biliary drain insertion, donor's BMI, and serum cholesterol level were independent risk factors for developing bile stones on top of biliary strictures. Biliary stones were associated with high episodes of acute graft rejection, and they could be successfully managed by the ERCP modality.

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Impact of biliary complications on quality of life in live-donor liver transplant recipients

Cited by 4 publications

References 50 publications

Improving the radiological diagnosis of hepatic artery thrombosis after liver transplantation: Current approaches and future challenges

Improving the radiological diagnosis of hepatic artery thrombosis after liver transplantation: Current approaches and future challenges

Emergency Department Frequentation and Unscheduled Visits of Liver Transplant Patients: Ten Years Experience in Tertiary Care Center, Saudi Arabia

Risk factors and management of biliary stones after living donor liver transplant and its effect on graft outcome

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