Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation

Maureen M J Guichelaar, Joanne T. Benson, Michael Malinchoc, Ruud A F Kroma, Russell H. Wiesner, Michael R. Charlton

Research output: Contribution to journalArticle

197 Citations (Scopus)

Abstract

Non-anastomotic biliary stricture (NAS) formation is a major complication of liver transplantation. We prospectively determined the time to development of responsiveness to treatment, and clinical outcomes following NAS formation. In addition, an extensive analysis of the association of recipient, donor, and clinical variables with NAS formation was performed. A total of 749 consecutive patients was studied in a prospective, protocol-based fashion. Seventy-two patients (9.6%) developed NAS at a mean of 23.6± 34.2 weeks post-transplantation. Non-anastomotic biliary stricture formation resolved in only 6% of affected patients. Although patient survival was not affected, retransplantation and graft loss rates were significantly greater in recipients who developed NAS. In contrast to previous reports, a pretransplant diagnosis of HCV was associated with a low frequency of NAS formation. The incidence of NAS was independently associated with pretransplant diagnoses of PSC and autoimmune hepatitis. Hepatic artery thrombosis, and prolonged warm and cold ischemia times were also independent risk factors for NAS formation. We conclude that NAS developed in ∼10% of primary liver transplant recipients. A pretransplant diagnosis of autoimmune hepatitis has been identified as a novel independent risk factor for NAS formation. Development of NAS significantly attenuates graft but not patient survival.

Original languageEnglish (US)
Pages (from-to)885-890
Number of pages6
JournalAmerican Journal of Transplantation
Volume3
Issue number7
DOIs
StatePublished - Jul 2003

Fingerprint

Liver Transplantation
Pathologic Constriction
Autoimmune Hepatitis
Transplants
Cold Ischemia
Warm Ischemia
Survival
Hepatic Artery
Thrombosis
Transplantation
Tissue Donors

Keywords

  • Biliary strictures
  • Liver transplant

ASJC Scopus subject areas

  • Immunology

Cite this

Guichelaar, M. M. J., Benson, J. T., Malinchoc, M., Kroma, R. A. F., Wiesner, R. H., & Charlton, M. R. (2003). Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation. American Journal of Transplantation, 3(7), 885-890. https://doi.org/10.1034/j.1600-6143.2003.00165.x

Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation. / Guichelaar, Maureen M J; Benson, Joanne T.; Malinchoc, Michael; Kroma, Ruud A F; Wiesner, Russell H.; Charlton, Michael R.

In: American Journal of Transplantation, Vol. 3, No. 7, 07.2003, p. 885-890.

Research output: Contribution to journalArticle

Guichelaar, Maureen M J ; Benson, Joanne T. ; Malinchoc, Michael ; Kroma, Ruud A F ; Wiesner, Russell H. ; Charlton, Michael R. / Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation. In: American Journal of Transplantation. 2003 ; Vol. 3, No. 7. pp. 885-890.
@article{1d3cb17f375349fbbe56ff85e842ed01,
title = "Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation",
abstract = "Non-anastomotic biliary stricture (NAS) formation is a major complication of liver transplantation. We prospectively determined the time to development of responsiveness to treatment, and clinical outcomes following NAS formation. In addition, an extensive analysis of the association of recipient, donor, and clinical variables with NAS formation was performed. A total of 749 consecutive patients was studied in a prospective, protocol-based fashion. Seventy-two patients (9.6{\%}) developed NAS at a mean of 23.6± 34.2 weeks post-transplantation. Non-anastomotic biliary stricture formation resolved in only 6{\%} of affected patients. Although patient survival was not affected, retransplantation and graft loss rates were significantly greater in recipients who developed NAS. In contrast to previous reports, a pretransplant diagnosis of HCV was associated with a low frequency of NAS formation. The incidence of NAS was independently associated with pretransplant diagnoses of PSC and autoimmune hepatitis. Hepatic artery thrombosis, and prolonged warm and cold ischemia times were also independent risk factors for NAS formation. We conclude that NAS developed in ∼10{\%} of primary liver transplant recipients. A pretransplant diagnosis of autoimmune hepatitis has been identified as a novel independent risk factor for NAS formation. Development of NAS significantly attenuates graft but not patient survival.",
keywords = "Biliary strictures, Liver transplant",
author = "Guichelaar, {Maureen M J} and Benson, {Joanne T.} and Michael Malinchoc and Kroma, {Ruud A F} and Wiesner, {Russell H.} and Charlton, {Michael R.}",
year = "2003",
month = "7",
doi = "10.1034/j.1600-6143.2003.00165.x",
language = "English (US)",
volume = "3",
pages = "885--890",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation

AU - Guichelaar, Maureen M J

AU - Benson, Joanne T.

AU - Malinchoc, Michael

AU - Kroma, Ruud A F

AU - Wiesner, Russell H.

AU - Charlton, Michael R.

PY - 2003/7

Y1 - 2003/7

N2 - Non-anastomotic biliary stricture (NAS) formation is a major complication of liver transplantation. We prospectively determined the time to development of responsiveness to treatment, and clinical outcomes following NAS formation. In addition, an extensive analysis of the association of recipient, donor, and clinical variables with NAS formation was performed. A total of 749 consecutive patients was studied in a prospective, protocol-based fashion. Seventy-two patients (9.6%) developed NAS at a mean of 23.6± 34.2 weeks post-transplantation. Non-anastomotic biliary stricture formation resolved in only 6% of affected patients. Although patient survival was not affected, retransplantation and graft loss rates were significantly greater in recipients who developed NAS. In contrast to previous reports, a pretransplant diagnosis of HCV was associated with a low frequency of NAS formation. The incidence of NAS was independently associated with pretransplant diagnoses of PSC and autoimmune hepatitis. Hepatic artery thrombosis, and prolonged warm and cold ischemia times were also independent risk factors for NAS formation. We conclude that NAS developed in ∼10% of primary liver transplant recipients. A pretransplant diagnosis of autoimmune hepatitis has been identified as a novel independent risk factor for NAS formation. Development of NAS significantly attenuates graft but not patient survival.

AB - Non-anastomotic biliary stricture (NAS) formation is a major complication of liver transplantation. We prospectively determined the time to development of responsiveness to treatment, and clinical outcomes following NAS formation. In addition, an extensive analysis of the association of recipient, donor, and clinical variables with NAS formation was performed. A total of 749 consecutive patients was studied in a prospective, protocol-based fashion. Seventy-two patients (9.6%) developed NAS at a mean of 23.6± 34.2 weeks post-transplantation. Non-anastomotic biliary stricture formation resolved in only 6% of affected patients. Although patient survival was not affected, retransplantation and graft loss rates were significantly greater in recipients who developed NAS. In contrast to previous reports, a pretransplant diagnosis of HCV was associated with a low frequency of NAS formation. The incidence of NAS was independently associated with pretransplant diagnoses of PSC and autoimmune hepatitis. Hepatic artery thrombosis, and prolonged warm and cold ischemia times were also independent risk factors for NAS formation. We conclude that NAS developed in ∼10% of primary liver transplant recipients. A pretransplant diagnosis of autoimmune hepatitis has been identified as a novel independent risk factor for NAS formation. Development of NAS significantly attenuates graft but not patient survival.

KW - Biliary strictures

KW - Liver transplant

UR - http://www.scopus.com/inward/record.url?scp=0037675898&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037675898&partnerID=8YFLogxK

U2 - 10.1034/j.1600-6143.2003.00165.x

DO - 10.1034/j.1600-6143.2003.00165.x

M3 - Article

C2 - 12814481

AN - SCOPUS:0037675898

VL - 3

SP - 885

EP - 890

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 7

ER -