학술논문
Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation.
Document Type
Article
Author
Source
Subject
*LIVER transplantation
*BILE ducts
*GRAFT survival
*OVERALL survival
*HEPATIC artery
*MULTIVARIATE analysis
*INTRAHEPATIC bile ducts
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Language
ISSN
1756-0500
Abstract
Objectives: We aimed to analyze the risk factors for management failure of BC after pediatric liver transplantation (pLT) by retrospectively analyzing primary pLT performed between 1997 and 2018 (n = 620 patients). Results: In all, 117/620 patients (19%) developed BC. The median (range) follow-up was 9 (1.4–21) years. Patient survival at 1, 5 and 10 years was 88.9%, 85.7%, 84.4% and liver graft survival was 82.4%, 77.4%, and 74.3% respectively. Graft not patient survival was impaired by BC (p = 0.01). Multivariate analysis identified the number of dilatation courses > 2 (p = 0.008), prolonged cold ischemia time (p = 0.004), anastomosed multiple biliary ducts (p = 0.019) and hepatic artery thrombosis (p = 0.01) as factors associated with impaired graft survival. The number of dilatation courses > 2 (p < 0.001) and intrahepatic vs anastomotic stricture (p = 0.014) were associated with management failure. Thus, repeated (> 2) radiologic dilatation courses are associated with impaired graft survival and management failure. Overall, graft but not patient survival was impaired by BC. [ABSTRACT FROM AUTHOR]