Risk factors for and management of ischemic-type biliary lesions following orthotopic liver transplantation: A single center experience
Document title: Risk factors for and management of ischemic-type biliary lesions following orthotopic liver transplantation: A single center experience
Journal: Annals of hepatology
Database: PERIÓDICA
System number: 000413412
ISSN: 1665-2681
Authors: 1
1
1
1
1
2
Institutions: 1Capital Medical University, Beijing You-An Hospital, Beijing. China
2Chinese PLA General Hospital, Chinese PLA Medical School, Beijing. China
Year:
Season: Ene-Feb
Volumen: 15
Number: 1
Pages: 41-46
Country: México
Language: Inglés
Document type: Artículo
Approach: Analítico, descriptivo
English abstract Introduction. Biliary complications can cause morbidity, graft loss, and mortality after liver transplantation. The most troublesome biliary complications are ischemic-type biliary lesions (ITBL), which occur since transplants can now be performed after the donor has undergone circulatory death. The exact origin of this type of biliary complication remains unknown. Material and methods. Material and methods. A Material and methods. total of 528 patients were retrospectively analyzed following liver transplantation after excluding 30 patients with primary sclerosing cholangitis and those lost to follow-up from January 2007 to January 2014. The incidence of and risk factors for ITBL were evaluated. Results. Results. Results. Cold ischemia time (CIT) (P = 0.042) and warm ischemia time (WIT) (P = 0.006) were found to be independent risk factors for the development of ITBL. Use of the cytochrome P450 (CYP) 3A5 genotype assay to guide individualization of immunosuppressive medications resulted in significantly fewer ITBL (P = 0.027. Autoimmune hepatitis might be a risk factor for ITBL, as determined using univariate analysis (P = 0.047). Conclusions. Conclusions. Efforts should be taken to minimize risk factors associated with ITBL, such as CIT and WIT. The CYP3A5 genotype assay should be used to guide selection of immunosuppressive therapy in an effort to reduce the occurrence of ITBL
Disciplines: Medicina
Keyword: Cirugía,
Gastroenterología,
Trasplante de hígado,
Complicaciones postoperatorias,
Lesión isquémica,
Factores de riesgo
Keyword: Medicine,
Gastroenterology,
Surgery,
Liver transplantation,
Postoperative complications,
Ischemic injury,
Risk factors
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