Early laboratory values after liver transplantation are associated with anastomotic biliary strictures

Matthew Fasullo; Priyanush Kandakatla; Reza Amerinasab; Divyanshoo Rai Kohli; Tilak Shah; Samarth Patel; Chandra Bhati; Doumit Bouhaidar; Mohammad S. Siddiqui; Ravi Vachhani

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저자정보: Matthew Fasullo (Virginia Commonwealth University Medical Center) Priyanush Kandakatla (Virginia Commonwealth University Medical Center) Reza Amerinasab (Virginia Commonwealth University Medical Center) Divyanshoo Rai Kohli (Kansas City VA Medical Center) Tilak Shah (Hunter Holmes McGuire VA Medical Center) Samarth Patel (Hunter Holmes McGuire VA Medical Center) Chandra Bhati (Virginia Commonwealth University Medical Center) Doumit Bouhaidar (Virginia Commonwealth University Medical Center) Mohammad S. Siddiqui (Virginia Commonwealth University Medical Center) Ravi Vachhani (Virginia Commonwealth University Medical Center)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제26권 제1호

발행연도: 2022.2

수록면: 76 - 83 (8page)

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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.

#Liver transplantation #Common bile duct #Cholangiopancreatography #endoscopic retrograde #Bile ducts #Magnetic resonance imaging

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