Risk factors for and management of ischemic-type biliary lesions following orthotopic liver transplantation: A single center experience
Título del documento: Risk factors for and management of ischemic-type biliary lesions following orthotopic liver transplantation: A single center experience
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000413412
ISSN: 1665-2681
Autores: 1
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2
Instituciones: 1Capital Medical University, Beijing You-An Hospital, Beijing. China
2Chinese PLA General Hospital, Chinese PLA Medical School, Beijing. China
Año:
Periodo: Ene-Feb
Volumen: 15
Número: 1
Paginación: 41-46
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés 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
Disciplinas: Medicina
Palabras clave: 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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