Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

• Published in: World journal of gastroenterology : WJG Vol. 13; no. 20; pp. 2819 - 2825
• Main Authors: Shastri, Yogesh M, Hoepffner, Nicolas M, Akoglu, Bora, Zapletal, Christina, Bechstein, Wolf O, Caspary, Wolfgang F, Faust, Dominik
• Format: Journal Article
• Language: English
• Published: United States Department of Medicine I,J.W. Goethe-University Hospital, Theodor-Stern-Kai 7, D - 60590 Frankfurt am Main, Germany%Department of Surgery,Theodor-Stern-Kai 7, D-60590, J.W. Goethe University Hospital,Frankfurt am Main, Germany 28.05.2007; Baishideng Publishing Group Co., Limited
• Subjects: Adult; Alanine Transaminase - blood; Alkaline Phosphatase - blood; Aspartate Aminotransferases - blood; Biliary Tract Diseases - diagnosis; Biliary Tract Diseases - etiology; Biliary Tract Diseases - therapy; Biomarkers - blood; Cholangiopancreatography, Endoscopic Retrograde; Clinical Research; Drainage; Female; gamma-Glutamyltransferase - blood; Humans; Liver - metabolism; Liver Transplantation - adverse effects; Male; Middle Aged; Endoscopic therapy; Biliary lesion; Orthotopic liver transplantation; Liver biochemistry; Ischemic type biliary lesions
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v13.i20.2819

To correlate the significance of liver biochemical tests in diagnosing post orthotopic liver transplantation (OLT) biliary complications and to study their profile before and after endoscopic therapy. Patients who developed biliary complications were analysed in detail for the clinical information, laboratory tests, treatment offered, response to it, follow up and outcomes. The profile of liver enzymes was determined. The safety, efficacy and outcomes of endoscopic retrograde cholangiography (ERC) were also analysed. 40 patients required ERC for 70 biliary complications. GGT was found to be > 3 times (388.1 +/- 70.9 U/mL vs 168.5 +/- 34.2 U/L, P=0.007) and SAP > 2 times (345.1 +/- 59.1 U/L vs 152.7 +/- 21.4 U/L, P=0.003) the immediate post OLT values. Most frequent complication was isolated anastomotic strictures in 28 (40%). Sustained success was achieved in 26 (81%) patients. Biliary complications still remain an important problem post OLT. SAP and GGT can be used as early, non-invasive markers for diagnosis and also to assess the adequacy of therapy. Endoscopic management is usually effective in treating the majority of these biliary complications.