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Published on: November 7, 2020
Complications after ERCP in liver transplant recipients
Domingo Balderramo1, Josep M Bordas, Oriol Sendino
1GI/Endoscopy Unit, Institut de Malalties Digestives i Metaboliques, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Gastrointestinal Endoscopy
|June 28, 2011
Summary
Complications after ERCP in liver transplant recipients occurred in 9% of cases, similar to non-transplant patients. Risk factors include mTOR inhibitors, renal failure, and sphincterotomy, while steroids showed a protective effect.
Area of Science:
- Hepatology
- Gastroenterology
- Transplantation Surgery
Background:
- Biliary tract complications post-liver transplantation (LT) are often managed with ERCP.
- However, the incidence and risk factors for complications following ERCP in LT recipients are not well-established.
Purpose of the Study:
- To determine the incidence and identify risk factors for post-ERCP complications in liver transplant recipients.
- To evaluate the short-term outcomes of these complications.
Main Methods:
- A retrospective analysis of 243 ERCP procedures performed in 121 LT recipients over a 7-year period.
- Data were collected from a tertiary referral center, focusing on patients with duct-to-duct anastomosis.
- Predictive factors for complications were identified using univariate and multivariate analyses.
Main Results:
- Overall complication rate was 9%, including pancreatitis (3.7%), cholangitis (3.3%), and bleeding (1.6%).
- Independent risk factors for complications were identified as mammalian target of rapamycin inhibitors, serum creatinine > 2 mg/dL, biliary sphincterotomy, and >2 pancreatic duct contrast injections.
- Steroid therapy was found to be a protective factor.
Conclusions:
- The complication rate of ERCP in LT recipients is comparable to that in non-LT recipients.
- Specific patient characteristics and procedural elements, such as mTOR inhibitor use, renal failure, and sphincterotomy, increase complication risk.
- Steroid therapy may offer protection against post-ERCP complications in this population.
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