Intrahepatic biliary strictures after liver transplantation
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W L Campbell1, R Sheng, A B Zajko
1Department of Radiology, University of Pittsburgh School of Medicine, PA 15213.
Purpose:
To evaluate the prevalence, cholangiographic features, causes, and management of intrahepatic biliary strictures in hepatic transplants.
Materials And Methods:
Over a 12-year period, cholangiography was performed in 1,590 liver allografts. Confirmed cases of stricture were evaluated and correlated with clinical variables.
Results:
Intrahepatic biliary strictures occurred in 130 of 1,590 grafts (8.2%). Strictures were multiple in 99 grafts (76.2%) and single in 31 (23.8%). Locations were the common hepatic duct bifurcation in 46 grafts (35.4%), the peripheral ducts in 44 (33.8%), and both in 40 (30.8%). Strictures caused mild to moderate bile duct dilatation in 72 grafts (55.4%), marked dilatation in 11 (8.5%), and obstruction in four (3.1%). Hepatic artery occlusion, pretransplantation primary sclerosing cholangitis, choledochojejunostomy, use of Euro-Collins organ preservation solution, cholangitis at liver biopsy, and young age were statistically significantly associated with strictures (P < .001).
Conclusion:
Strictures have multiple causes and may be an important indicator of underlying abnormalities. They often require interventional radiologic or surgical treatment.
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