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anastomotic stricture liver transplant

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https://www.readbyqxmd.com/read/29785075/biliary-strictures-complicating-living-donor-liver-transplantation-problems-novel-insights-and-solutions
#1
REVIEW
Harshavardhan B Rao, Arjun Prakash, Surendran Sudhindran, Rama P Venu
Biliary stricture complicating living donor liver transplantation (LDLT) is a relatively common complication, occurring in most transplant centres across the world. Cases of biliary strictures are more common in LDLT than in deceased donor liver transplantation. Endoscopic management is the mainstay for biliary strictures complicating LDLT and includes endoscopic retrograde cholangiography, sphincterotomy and stent placement (with or without balloon dilatation). The efficacy and safety profiles as well as outcomes of endoscopic management of biliary strictures complicating LDLT is an area that needs to be viewed in isolation, owing to its unique set of problems and attending complications; as such, it merits a tailored approach, which is yet to be well established...
May 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29574569/internal-biliary-stenting-in-liver-transplantation
#2
Edouard Girard, Olivier Risse, Julio Abba, Maud Medici, Vincent Leroy, Mircea Chirica, Christian Letoublon
PURPOSE: Internal biliary stenting (IBS) was reported to decrease biliary complications after liver transplantation (LT) but data in literature is scarce. The aim of the present study was to evaluate our experience with end-to-end choledoco-choledocostomy during liver transplantation with special focus on the influence of IBS on patient and biliary outcomes. METHODS: Between 2009 and 2013, 175 patients underwent deceased donor LT with end-to-end choledoco-choledocostomy and were included in the study...
March 24, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29571064/spontaneous-migration-of-thrombosed-synthetic-vascular-graft-to-the-duodenum-after-living-donor-liver-transplantation-a-case-report
#3
Ahmed Mohamed Sultan, Ahmed Shehta, Tarek Salah, Mohamed Elshoubary, Mohamed Abdel Wahab
INTRODUCTION: Spontaneous migration of synthetic grafts had been described after abdominal vascular procedures into the duodenum and small bowel. In the setting of liver transplantation, synthetic grafts are commonly used for overcoming shortened or poor-quality vasculatures. We describe a case of spontaneous migration of thrombosed synthetic vascular graft after living-donor liver transplantation (LDLT). PRESENTATION: A 59 years male patient with end stage liver disease underwent LDLT utilizing a right hemi-liver graft...
March 15, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29457045/efficacy-of-endoscopic-retrograde-cholangiopancreatography-in-the-treatment-of-biliary-complications-following-liver-transplant-10-years-of-a-single-centre-experience
#4
Ana Rita Alves, Dário Gomes, Emanuel Furtado, Luís Tomé
Background and Aims: Biliary tract complications following liver transplant remain an important source of morbidity and mortality. Endoscopic retrograde cholangiopancreatography (ERCP) has become a common therapeutic option before other invasive procedures. The aim of this study was to evaluate ERCP efficacy in managing this type of complications. Methods: Retrospective study of all patients who underwent therapeutic ERCP due to post-liver transplant biliary complications between September 2005 and September 2015, at a deceased donor liver transplantation centre...
January 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29389767/outcomes-of-donation-after-cardiac-death-liver-grafts-from-donors-%C3%A2-50-years-of-age-a-multi-center-analysis
#5
Kristopher P Croome, Amit K Mathur, David D Lee, Adyr A Moss, Charles B Rosen, Julie K Heimbach, C Burcin Taner
INTRODUCTION: As the population in the United States continues to age, an increase in the number of potential DCD donors with advanced chronological age can be expected. The aim of this study was to analyze a multi-institutional experience in liver transplantation using DCD donor age ≥50 years. METHODS: All DCD LT performed at Mayo Clinic Florida, Mayo Clinic Rochester and Mayo Clinic Arizona from 2002-2016 were included. Recipients of DCD LT were divided into 2 groups: those with donor age ≥50 years(N=155) and those with donor age <50 years(N=316)...
January 31, 2018: Transplantation
https://www.readbyqxmd.com/read/29360615/patient-and-graft-survival-biliary-complications-after-liver-transplantation
#6
Michael Senter-Zapata, Adeel S Khan, Tanvi Subramanian, Neeta Vachharajani, Leigh Anne Dageforde, Jason R Wellen, Surendra Shenoy, Maria B Majella Doyle, William C Chapman
BACKGROUND: Biliary complications (BCs) affect up to to 34% of liver transplant recipients and are a major source of morbidity and cost. This is a 13-year review of BCs after liver transplantation (LT) at a tertiary care center. STUDY DESIGN: We conducted a single-center retrospective review of our prospective database to assess BCs in adult (aged 18 years or older) liver transplant recipients during a 13-year period (2002 to 2014). Biliary complications were divided into 3 subgroups: leak alone (L), stricture alone (S), and both leak and strictures (LS)...
April 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29312864/risk-factors-and-clinical-indicators-for-the-development-of-biliary-strictures-post-liver-transplant-significance-of-bilirubin
#7
Elizabeth Ann Forrest, Janske Reiling, Geraldine Lipka, Jonathan Fawcett
AIM: To identify risk factors associated with the formation of biliary strictures post liver transplantation over a period of 10-year in Queensland. METHODS: Data on liver donors and recipients in Queensland between 2005 and 2014 was obtained from an electronic patient data system. In addition, intra-operative and post-operative characteristics were collected and a logistical regression analysis was performed to evaluate their association with the development of biliary strictures...
December 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/29290658/characteristics-of-fecal-microbial-communities-in-patients-with-non-anastomotic-biliary-strictures-after-liver-transplantation
#8
Jing Zhang, Feng-Gang Ren, Peng Liu, Hong-Ke Zhang, Hao-Yang Zhu, Zhe Feng, Xu-Feng Zhang, Bo Wang, Xue-Ming Liu, Xiao-Gang Zhang, Rong-Qian Wu, Yi Lv
AIM: To explore the possible relationship between fecal microbial communities and non-anastomotic stricture (NAS) after liver transplantation (LT). METHODS: A total of 30 subjects including 10 patients with NAS, 10 patients with no complications after LT, and 10 non-LT healthy individuals were enrolled. Fecal microbial communities were assessed by the 16S rRNA gene sequencing technology. RESULTS: Different from the uncomplicated and healthy groups, unbalanced fecal bacterium ratio existed in patients with NAS after LT...
December 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29193362/donor-specific-anti-hla-antibodies-are-not-associated-with-nonanastomotic-biliary-strictures-but-both-are-independent-risk-factors-for-graft-loss-after-liver-transplantation
#9
Anne Claire den Dulk, Xiaolei Shi, Cornelia J Verhoeven, Jeroen Dubbeld, Frans H J Claas, Ron Wolterbeek, Simone H Brand-Schaaf, Hein W Verspaget, Arantza Fariña Sarasqueta, Luc J W van der Laan, Herold J Metselaar, Bart van Hoek, Jaap Kwekkeboom, Dave L Roelen
Donor-specific alloantibodies (DSA) have been associated with rejection and shorter graft survival after orthotopic liver transplantation (OLT). We examined the role of DSA in nonanastomotic biliary strictures (NAS) after OLT. Patients receiving first OLT who developed NAS (n = 68) and a control group without NAS (n = 83), with pre-OLT and 12 months post-OLT serum samples, were included. DSA were specified using the Luminex single antigen test. Risk factors for NAS and graft survival were analyzed. The presence of preformed DSA was not significantly different between patients with NAS and controls (P = ...
February 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29192137/application-of-fully-covered-self-expandable-metallic-stents-with-and-without-antimigration-waist-versus-repeated-plastic-biliary-stent-placement-in-management-of-anastomotic-biliary-strictures-after-orthotopic-liver-transplantation
#10
Samir Zeair, Filip Butkiewicz, Jacek Butkiewicz, Robert Stasiuk
BACKGROUND Standard methods for endoscopic retrograde cholangiopancreatography (ERCP) management of anastomotic strictures (AS) after OLT includes repeated balloon dilation of the stricture with subsequent insertion of a plastic biliary stent (PBS). In post-OLT patients not responding to standard endoscopic treatment, the placement of fully covered self-expanding metal stents (FCSEMS) is a valid alternative to surgical treatment. The aim of this study was to compare the results of new FCSEMS implantation with the standard ERCP stricture management protocol and with conventional FCSEMS insertion...
December 1, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29160909/revisiting-chronic-rejection-following-living-donor-liver-transplantation-in-the-tacrolimus-era-a-single-center-experience
#11
Narendra Singh Choudhary, Neeraj Saraf, Sanjiv Saigal, Dheeraj Gautam, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Thiagrajan Srinivasan, Sanjay Kumar Yadav, Arvinder Soin
BACKGROUND AND AIMS: Chronic rejection (CR) is an uncommon but important cause of graft dysfunction, leading to graft loss and often requires retransplantation. This study evaluates the incidence and outcome of the patients with CR at a large living donor liver transplant (LDLT) center. METHODS: Data of patients with CR were retrospectively analyzed in 1232 adult (age >18 years) LDLT on tacrolimus (mainly)-based immunosuppression. Sirolimus/everolimus (mammalian target of rapamycin [mTOR] inhibitors) was added to baseline immunosuppression as rescue therapy in patients with CR...
February 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29096343/non-anastomotic-strictures-after-transplanting-a-liver-graft-with-an-accidentally-ligated-and-unflushed-common-bile-duct-a-case-report
#12
Nicolas Meurisse, Jacques Pirenne, Diethard Monbaliu
INTRODUCTION: Non-anastomotic biliary strictures (NAS) represent a major cause of morbidity, graft loss, and mortality after liver transplantation (LTx). NAS can result from an ischemic/immune-mediated injury, or from the cytotoxic effect that bile salts have on the biliary mucosa under hypothermic conditions. For this reason it is crucial to flush the bile duct at the time of procurement. PRESENTATION OF CASE: We report a case of an imported liver with an accidentally ligated and subsequently completely unflushed common bile duct...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29090502/endoscopic-treatment-of-anastomotic-biliary-stricture-after-adult-deceased-donor-liver-transplantation-with-multiple-plastic-stents-versus-self-expandable-metal-stents-a-systematic-review-and-meta-analysis
#13
Filippo Landi, Nicola de'Angelis, Ailton Sepulveda, Aleix Martínez-Pérez, Iradj Sobhani, Alexis Laurent, Olivier Soubrane
Anastomotic biliary strictures (ABSs) occur in up to 15% of patients after liver transplantation (LT). The aim of this study was to compare the efficacy and safety of self-expandable metal stents (SEMS) versus multiple plastic stents (MPS). Databases were searched through April 2017. The outcome measures were technical success, stricture resolution, recurrence and complications. We synthesized the findings descriptively and performed a meta-analysis. Three randomized controlled trials and one retrospective cohort study were identified, including 179 MPS and 119 SEMS patients...
February 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29055929/endoscopic-therapy-is-effective-for-recurrent-anastomotic-biliary-strictures-after-orthotopic-liver-transplantation
#14
Sun-Chuan Dai, David Goldberg, Amol Agarwal, Gene K Ma, Clinton Yam, Nuzhat A Ahmad, Gregory G Ginsberg, David L Jaffe, Michael L Kochman, Kim M Olthoff, Vinay Chandrasekhara
INTRODUCTION: Orthotopic liver transplantation anastomotic biliary strictures (OLT ABS) are managed with endoscopic biliary stent therapy but the recurrence rate is substantial. Our aims were to retrospectively determine the recurrence rates of OLT ABS after initial successful stent therapy, characterize the management of recurrences and identify associated variables. MATERIALS AND METHODS: Clinical data from 943 patients receiving non-living donor OLT at our institution from 2005-2012 were reviewed, and 123 OLT ABS patients receiving stent therapy were identified...
November 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29026597/endoscopic-approach-for-management-of-biliary-strictures-in-liver-transplant-recipients-a-systematic-review-and-meta-analysis
#15
Dayse Pereira da Silva Aparício, José Pinhata Otoch, Edna Frasson de Souza Montero, Muhammad Ali Khan, Everson Luiz de Almeida Artifon
The most common biliary complication after liver transplantation is anastomotic stricture (AS) and it can occur isolated or in combination with other complications. Liver graft from a cadaveric donor or a living donor has an influence on the incidence of biliary strictures as well as on the response to endoscopic treatment. Endoscopic treatment using balloon dilation and insertion of biliary stents by endoscopic retrograde cholangiopancreatography (ERCP) is the initial approach to these complications. AIM: The aim of this article is to compare different endoscopic techniques to treat post-liver transplantation biliary strictures...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29025382/biliary-complications-in-recipients-of-living-donor-liver-transplant-a-single-center-review-of-120-patients
#16
Mohamed D Sarhan, Ayman M A Osman, Mahmoud Aly Mohamed, Omar Abdelaziz, Dalia K Serour, Doaa A Mansour, Sherif Mogawer, Ayman S Helmy, Mostafa A El-Shazli, Adel A Hosny
OBJECTIVES: Biliary complications are common after living-donor liver transplant. This retrospective study reviewed our experience with biliary complications in recipients of living-donor liver transplant. MATERIALS AND METHODS: Over our 9-year study period, 120 patients underwent living-donor liver transplant. Patients were divided into 2 groups, with group A having biliary complications and group B without biliary complications. Both groups were compared, and different treatment modalities for biliary complications were evaluated...
December 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28931801/elizabethkingia-meningoseptica-in-a-case-of-biliary-tract-infection-following-liver-transplantation
#17
Hebah M Musalem, Yazan N Honjol, Lin M Tuleimat, Saleh I Al Abbad, Fahad I Alsohaibani
BACKGROUND Elizabethkingia meningoseptica (E. meningoseptica) is an aerobic Gram-negative bacillus known to thrive in moist environments, and is now recognized as a hospital-acquired infection, being found to contaminate hospital equipment, respiratory apparatus, hospital solutions, water, and drainage systems. Nosocomial infection with E. meningoseptica occurs in immunocompromised patients, requires specialized identification methods, and is resistant to conventional antibiotics. We report a case of E. meningoseptica infection arising from a percutaneous transhepatic biliary drainage (PTBD) tube...
September 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28905337/cholangioscopy-assisted-guidewire-placement-in-post-liver-transplant-anastomotic-biliary-stricture-efficient-and-potentially-also-cost-effective
#18
Fernanda P Martins, Angelo P Ferrari
No abstract text is available yet for this article.
November 2017: Endoscopy
https://www.readbyqxmd.com/read/28837510/use-of-fully-covered-self-expanding-metal-biliary-stents-in-pediatrics-a-case-series
#19
Jacob A Mark, Cara L Mack, Ahmed I Marwan, Robert E Kramer
OBJECTIVES: Endoscopic retrograde cholangiopancreatography is used to manage biliary pathology in pediatric patients. Plastic biliary stents have been used in this population for obstructive lesions and bile leaks; however, they are sometimes not effective due to migration, occlusion, or ineffective sealing. Fully covered self-expanding metal stents (FCSEMS) have larger diameters making them more suitable for some situations. Their use in pediatrics has, however, not been defined. The aim of the present study is to describe our experience with FCSEMS at our institution...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28757315/liver-transplant-related-anastomotic-biliary-strictures-a-novel-rapid-safe-radiation-sparing-and-cost-effective-management-approach
#20
Monique T Barakat, Robert J Huang, Nirav C Thosani, Abhishek Choudhary, Mohit Girotra, Subhas Banerjee
BACKGROUND AND AIMS: Biliary strictures after orthotopic liver transplantation (OLT) are typically managed by sequential ERCP procedures, with incremental dilation of the stricture and stent exchange (IDSE) and placement of new stents. This approach resolves >80% of strictures after 12 months but requires costly, lengthy ERCPs with significant patient radiation exposure. Increasing awareness of the harmful effects of radiation, escalating healthcare costs, and decreasing reimbursement for procedures mandate maximal efficiency in performing ERCP...
February 2018: Gastrointestinal Endoscopy
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