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anastomotic stricture liver transplant

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https://www.readbyqxmd.com/read/28427741/management-of-biliary-anastomotic-strictures-after-liver-transplantation
#1
REVIEW
Aydin Seref Koksal, Ahmet Tarik Eminler, Erkan Parlak, Ahmet Gurakar
Biliary strictures constitute 40% to 60% of the biliary complications after liver transplantation. They are more common after living donor related liver transplantation (LDLT) than orthotopic liver transplantation (OLT). Balloon dilation followed by multiple plastic stent insertion leads to a mean resolution rate of 84% in the treatment of ASs after OLT. Endoscopic treatment of ASs after LDLT is more difficult because of the small size of the ASs, their multiple number and peripheral location. Balloon dilation followed by multiple plastic stent insertion had a mean resolution rate of 53%...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28426684/long-term-results-after-transplantation-of-pediatric-liver-grafts-from-donation-after-circulatory-death-donors
#2
Rianne van Rijn, Pieter E R Hoogland, Frank Lehner, Ernest L W van Heurn, Robert J Porte
BACKGROUND: Liver grafts from donation after circulatory death (DCD) donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD) donors. METHOD: All transplantations performed with a liver from a pediatric donor (≤16 years) in the Netherlands between 2002 and 2015 were included...
2017: PloS One
https://www.readbyqxmd.com/read/28409358/added-value-of-gadoxetic-acid-enhanced-t1-weighted-magnetic-resonance-cholangiography-for-the-diagnosis-of-post-transplant-biliary-complications
#3
Sonja Kinner, Tilman B Schubert, Adnan Said, Joshua D Mezrich, Scott B Reeder
OBJECTIVES: Biliary complications after liver transplantation (LT) are common. This study aimed to ascertain the value of gadoxetic acid-enhanced T1-weighted (T1w) magnetic resonance cholangiography (MRC) to evaluate anastomotic strictures (AS), non-anastomotic strictures (NAS) and biliary casts (BC). METHODS: Sixty liver-transplanted patients with suspicion of biliary complications and T2w-MRCP and T1w-MRC followed by endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) were analysed...
April 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28394402/dual-hypothermic-oxygenated-machine-perfusion-in-liver-transplants-donated-after-circulatory-death
#4
R van Rijn, N Karimian, A P M Matton, L C Burlage, A C Westerkamp, A P van den Berg, R H J de Kleine, M T de Boer, T Lisman, R J Porte
BACKGROUND: Experimental studies have suggested that end-ischaemic dual hypothermic oxygenated machine perfusion (DHOPE) may restore hepatocellular energy status and reduce reperfusion injury in donation after circulatory death (DCD) liver grafts. The aim of this prospective case-control study was to assess the safety and feasibility of DHOPE in DCD liver transplantation. METHODS: In consecutive DCD liver transplantations, liver grafts were treated with end-ischaemic DHOPE...
April 10, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28331447/novel-biliary-reconstruction-techniques-during-liver-transplantation
#5
Ian C Carmody, John Romano, Humberto Bohorquez, Emily Bugeaud, David S Bruce, Ari J Cohen, John Seal, Trevor W Reichman, George E Loss
BACKGROUND: Biliary complications remain a significant problem following liver transplantation. Several surgical options can be used to deal with a significant size mismatch between the donor and recipient bile ducts during the biliary anastomosis. We compared biliary transposition to recipient biliary ductoplasty in cadaveric liver transplant. METHODS: A total of 33 reconstructions were performed from January 1, 2005 to December 31, 2013. In the biliary transposition group (n=23), 5 reconstructions were performed using an internal stent (5 or 8 French pediatric feeding tube), and 18 were performed without...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28319567/treatment-of-biliary-stricture-after-live-donor-liver-transplantation-with-combined-metal-and-plastic-stent-%C3%A4-nsertion-a-feasibility-and-safety-study
#6
Erkan Parlak, Aydin Seref Koksal, Ahmet Tarik Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND: Fully covered-self expandable metal stents (Fc-SEMSs) have a challenging use in the treatment of anastomosis strictures (ASs) after live donor liver transplantation (LDLT) because they can occlude secondary branch biliary ducts when placed above the biliary bifurcation. In this study we evaluated the technical feasibility and safety of combining Fc-SEMSs with plastic stent(s) inserted to the secondary branch biliary ducts for the treatment of ASs after LDLT. METHODS: The study group included 22 patients (12 men, aged 51±11 years) with anastomotic biliary stricture after LDLT...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28302527/multiple-plastic-stents-versus-covered-metal-stent-for-treatment-of-anastomotic-biliary-strictures-after-liver-transplantation-a-prospective-randomized-multicenter-trial
#7
Andrea Oliver Tal, Fabian Finkelmeier, Natalie Filmann, Leena Kylänpää, Marianne Udd, Ilaria Parzanese, Paolo Cantù, Alexander Dechêne, Volker Penndorf, Andreas Schnitzbauer, Mireen Friedrich-Rust, Stefan Zeuzem, Jörg G Albert
BACKGROUND AND AIMS: Treatment of anastomotic biliary strictures (ABSs) after orthotopic liver transplantation (OLT) by endoscopic insertion of multiple plastic stents (MPSs) is well-established. The use of covered self-expandable metal stents (cSEMSs) for this indication is less investigated. METHODS: In an open-label, multicenter, randomized trial, patients with confirmed ABSs were randomly assigned 1:1 to receive either an MPS or a cSEMS. Primary endpoint was the number of endoscopic interventions until ABS resolution...
March 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28260480/living-donor-liver-transplant-follow-up-a-singlecenter-experience
#8
Syed Mudassir Laeeq, Farina M Hanif, Nasir Hassan Luck, Rajesh Kumar Mandhwani, Jawed Iqbal, Syed Haider Mehdi
OBJECTIVES: Liver transplant is a definite treatment of decompensated liver disease. Because of the shortage of livers from deceased donors, living-donor liver transplant is becoming more common. Here, we analyzed our clinical experience in the follow-up care of these patients. MATERIALS AND METHODS: Liver transplant recipients seen at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan) were included in this analysis. Baseline characteristics and follow-up events were recorded...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28246547/salvage-therapy-using-self-expandable-metal-stents-for-recalcitrant-anastomotic-strictures-after-living-donor-liver-transplantation
#9
Sung Ill Jang, Se Yong Sung, Hyunsung Park, Kwang-Hun Lee, Seung-Moon Joo, Dong Ki Lee
BACKGROUND: Recently, there has been an increase in clinical success rates using nonsurgical methods to resolve anastomotic biliary strictures (ABSs) that develop after liver transplantation (LT). However, some strictures are particularly refractory and cannot be completely resolved by an endoscopic or percutaneous procedure. Consequently, the aim of this study was to examine the feasibility and efficacy of using a newly designed fully covered self-expandable metal stent (FCSEMS) to resolve refractory ABS...
March 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28217251/biliary-complications-following-liver-transplantation-single-center-experience-over-three-decades-and-recent-risk-factors
#10
Alexander Kaltenborn, André Gutcke, Jill Gwiasda, Jürgen Klempnauer, Harald Schrem
AIM: To identify independent risk factors for biliary complications in a center with three decades of experience in liver transplantation. METHODS: A total of 1607 consecutive liver transplantations were analyzed in a retrospective study. Detailed subset analysis was performed in 417 patients, which have been transplanted since the introduction of Model of End-Stage Liver Disease (MELD)-based liver allocation. Risk factors for the onset of anastomotic biliary complications were identified with multivariable binary logistic regression analyses...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28128721/effect-of-right-posterior-bile-duct-anatomy-on-biliary-complications-in-patients-undergoing-right-lobe-living-donor-liver-transplant
#11
Tugan Tezcaner, Nadire Dinç, Feza Y Karakayalı, Mahir Kırnap, Mehmet Coşkun, Gökhan Moray, Mehmet Haberal
OBJECTIVES: Our aim was to evaluate the influence of the localization of right posterior bile duct anatomy relative to portal vein of the donors on posttransplant bile duct complications. MATERIALS AND METHODS: We retrospectively investigated 141 patients who had undergone living donor liver transplant using right hemiliver grafts. The patients were classified based on the pattern of the right posterior bile duct and divided into infraportal and supraportal types...
January 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28118992/evaluation-of-biliary-complications-on-magnetic-resonance-cholangiopancreatography-and-comparison-with-direct-cholangiography-after-living-donor-liver-transplantation
#12
B Garg, R Rastogi, S Gupta, H Rastogi, H Garg, V Chowdhury
AIM: To evaluate the imaging characteristics of biliary complications following liver transplantation on magnetic resonance cholangiopancreatography (MRCP) and its diagnostic accuracy in comparison with direct cholangiography. MATERIAL AND METHODS: In this prospective study, 34 patients being evaluated for possible biliary complications after living-donor liver transplantation (LDLT) with abnormal MRCP findings were followed up for information regarding direct cholangiography either endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) within 7 days of MRCP...
January 21, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28104994/cutting-balloon-treatment-of-anastomotic-biliary-stenosis-after-liver-transplantation-report-of-two-cases
#13
Fan Ding, Hui Tang, Chi Xu, Zai-Bo Jiang, Shu-Hong Yi, Hua Li, Nan Jiang, Wen-Jie Chen, Qing Yang, Yang Yang, Gui-Hua Chen
Biliary stenosis is a common complication after liver transplantation, and has an incidence rate ranging from 4.7% to 12.5% based on our previous study. Three types of biliary stenosis (anastomotic stenosis, non-anastomotic peripheral stenosis and non-anastomotic central hilar stenosis) have been identified. We report the outcome of two patients with anastomotic stricture after liver transplantation who underwent successful cutting balloon treatment. Case 1 was a 40-year-old male transplanted due to subacute fulminant hepatitis C...
January 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27931575/bile-duct-anastomosis-supplied-with-biodegradable-stent-in-liver-transplantation-the-initial-experience
#14
RANDOMIZED CONTROLLED TRIAL
L Janousek, S Maly, M Oliverius, M Kocik, M Kucera, J Fronek
BACKGROUND: The most common biliary complications after orthotopic liver transplantation are bile leaks, anastomotic and intrahepatic strictures, stones, and ampullary dysfunction. These complications can occur in up to 10% to 30% of liver transplant recipients. Leaks occur early in the posttransplant period; the stricture formation typically graduates over time. METHODS: Ten patients underwent transplantation in our preliminary study: 5 were randomized to the group with stent placement and 5 to the control group...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27925689/prognostic-significance-of-hepatic-arterial-collaterals-in-liver-transplant-recipients-with-biliary-strictures
#15
André Viveiros, Rafael Rehwald, Erich Vettori, Armin Finkenstedt, Maria Effenberger, Benedikt Schaefer, Livia Dorn, Herbert Tilg, Stefan Schneeberger, Bernhard Glodny, Heinz Zoller, Martin C Freund
BACKGROUND: The aim of this study was to determine the prevalence of hepatic artery stenosis (HAS) and the prognostic implications of hepatic arterial collaterals in liver transplant (LT) recipients with biliary strictures. METHODS: The 105 LT recipients transplanted between 2004 and 2015 at our center had documented biliary strictures. HAS and collaterals were assessed in high-quality imaging of the hepatic artery available from 66 recipients. Clinical, demographic, and biochemical recipient and donor data were retrospectively analyzed and tested for their association with biliary or arterial complications after LT...
February 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/27862815/systematic-review-and-meta-analysis-of-studies-of-biliary-reconstruction-in-adult-living-donor-liver-transplantation
#16
REVIEW
Kenneth S H Chok, Chung Mau Lo
BACKGROUND: The chance of biliary complication after living donor liver transplantation (LDLT) is considerable. The objective of this study was to investigate the impact of biliary reconstruction method on post-LDLT biliary complications. Data sources are from PubMed and Web of Science. METHODS: A systematic search was conducted using the search term '[biliary complications] OR [biliary complication] OR [biliary stricture] OR [bile leak] AND [living donor liver transplantation]'...
March 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27783454/successful-donation-after-cardiac-death-liver-transplants-with-prolonged-warm-ischemia-time-using-normothermic-regional-perfusion
#17
Riccardo De Carlis, Stefano Di Sandro, Andrea Lauterio, Fabio Ferla, Antonio Dell'Acqua, Marinella Zanierato, Luciano De Carlis
The role of donation after cardiac death (DCD) in expanding the donor pool is mainly limited by the incidence of primary nonfunction (PNF) and ischemia-related complications. Even greater concern exists toward uncontrolled DCD, which represents the largest potential pool of DCD donors. We recently started the first Italian series of DCD liver transplantation, using normothermic regional perfusion (NRP) in 6 uncontrolled donors and in 1 controlled case to deal with the legally required no-touch period of 20 minutes...
February 2017: Liver Transplantation
https://www.readbyqxmd.com/read/27744664/endoscopic-management-of-anastomotic-strictures-after-liver-transplantation
#18
REVIEW
Dong Wook Lee, Hyeong Ho Jo, Juveria Abdullah, Michel Kahaleh
Endoscopic treatment of biliary strictures involving plastic stent placement has been used widely. The use of self-expandable metal stents (SEMSs) has been described for anastomotic strictures following liver transplantation (LT). This review aimed to assess and compare the efficacy of plastic stents with SEMS in LT patients. Information was retrieved regarding technical success, stricture resolution, the number of endoscopic retrograde cholangiography procedures, follow-up, immediate, and late complications...
September 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27742337/endoscopic-management-of-post-liver-transplantation-biliary-strictures-with-the-use-of-fully-covered-metallic-stents
#19
M Jiménez-Pérez, J M Melgar Simón, A Durán Campos, R González Grande, J M Rodrigo López, R Manteca González
OBJECTIVE: The aim of this work was to evaluate the safety and efficacy of a fully covered self-expandable metal stent (FCSEMS) in the treatment of post-liver transplantation biliary strictures. METHODS: From October 2009 to October 2014, 44 patients with post-liver transplantation biliary stenosis were treated with the use of endoscopic retrograde cholangiography and placement of FCSEMS after informed consent. The FCSEMS was scheduled to remain in situ for 3-6 months...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27733316/portal-vein-stenting-as-a-significant-risk-factor-for-biliary-stricture-in-adult-living-donor-liver-transplantation
#20
Min-Ho Shin, Deok-Bog Moon, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Chul-Soo Ahn, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Young-In Yun, Wan-Jun Kim, Woo-Hyoung Kang, Seok-Hwan Kim, Gi-Young Ko
BACKGROUND: Although perioperative portal vein (PV) stent implantation is an effective treatment for steno-occlusive disease in adult living donor liver transplantation (LDLT) recipients, we experienced high incidence of biliary anastomotic strictures (BAS) after PV stenting. In this study, we sought to clarify the relation between BAS and PV stenting and to suggest the possible mechanism of BAS and measures to reduce its incidence. METHODS: We retrospectively analyzed 44 LDLT recipients who underwent PV stent implantation across the line of PV anastomosis regardless of the location of steno-occlusion (stent group) and their matched controls (non-stented LDLT recipients, n=131)...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
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