한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제26권1호
  • /
  • Pages.76-83
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  • 2022
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  • 2508-5778(pISSN)
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  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
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Early laboratory values after liver transplantation are associated with anastomotic biliary strictures

  • Matthew Fasullo (Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University Medical Center) ;
  • Priyanush Kandakatla (Department of Radiology, Virginia Commonwealth University Medical Center) ;
  • Reza Amerinasab (Department of Radiology, Virginia Commonwealth University Medical Center) ;
  • Divyanshoo Rai Kohli (Division of Gastroenterology and Hepatology, Kansas City VA Medical Center) ;
  • Tilak Shah (Division of Gastroenterology and Hepatology, Hunter Holmes McGuire VA Medical Center) ;
  • Samarth Patel (Division of Gastroenterology and Hepatology, Hunter Holmes McGuire VA Medical Center) ;
  • Chandra Bhati (Department of Transplant Surgery, Virginia Commonwealth University Medical Center) ;
  • Doumit Bouhaidar (Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University Medical Center) ;
  • Mohammad S. Siddiqui (Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University Medical Center) ;
  • Ravi Vachhani (Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University Medical Center)
  • 투고 : 2021.07.06
  • 심사 : 2021.09.29
  • 발행 : 2022.02.28
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초록

Backgrounds/Aims: The aim of this study was to evaluate longitudinal changes of post-liver transplantation (LT) biliary anatomy and to assess the association of increased laboratory values after LT with the development of post-LT anastomotic biliary stricture (ABS). Methods: Adult deceased donor LT recipients from 2008 and 2019 were evaluated. ABS was defined after blinded review of endoscopic cholangiograms. Controls were patients who underwent LT for hepatocellular carcinoma who did not have any clinical or biochemical concerns for ABS. Results: Of 534 patients who underwent LT, 57 patients had ABS and 57 patients served as controls. On MRI, ABS patients had a narrower anastomosis (2.47 ± 1.32 mm vs. 3.38 ± 1.05 mm; p < 0.01) and wider bile duct at 1-cm proximal to the anastomosis (6.73 ± 2.45 mm vs. 5.66 ± 1.95 mm; p = 0.01) than controls. Association between labs at day 7 and ABS formation was as follows: aspartate aminotransferase hazard ratio (HR): 1.014; 95% confidence interval (CI): 1.008-1.020, p = 0.001; total bilirubin HR: 1.292, 95% CI: 1.100-1.517, p = 0.002; and conjugated bilirubin HR: 1.467, 95% CI: 1.216-1.768, p = 0.001. Corresponding analysis results for day 28 were alanine aminotransferase HR: 1.004, 95% CI: 1.002-1.006, p = 0.001; alkaline phosphatase HR: 1.005, 95% CI: 1.003-1.007, p = 0.001; total bilirubin HR: 1.233, 95% CI: 1.110-1.369, p = 0.001; and conjugated bilirubin HR: 1.272, 95% CI: 1.126-1.437, p = 0.001. Conclusions: Elevation of laboratory values early after LT is associated with ABS formation.

키워드

참고문헌

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