Intrahepatic biliary lesions after orthotopic liver transplantation

• Published in: Transplant international Vol. 14; no. 3; pp. 129 - 134
• Main Authors: Rull, R., Garcia Valdecasas, J.C., Grande, L., Fuster, J., Lacy, A.M., González, F.X., Rimola, A., Navasa, M., Iglesias, C., Visa, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2001; Blackwell Publishing
• Subjects: ABO Blood-Group System; Adult; Bile Duct Diseases - etiology; Bile Ducts, Intrahepatic - blood supply; Bile Ducts, Intrahepatic - injuries; Biliary; Biological and medical sciences; Blood Group Incompatibility - complications; Chronic Disease; Female; Graft Rejection - complications; Hepatic Artery; Humans; Ischemia - etiology; Lesions; Liver; Liver Transplantation - adverse effects; Male; Medical sciences; Middle Aged; Miscellaneous; Organ Preservation - adverse effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thrombosis - complications; Thrombosis - etiology; Human; Liver; Mortality; Intrahepatic bile duct; Transplantation; Homotransplantation; Biliary tract disease; Morbidity; Incidence; Result; Etiology; Surgery; Digestive diseases
• ISSN: 0934-0874; 1432-2277
• DOI: 10.1111/j.1432-2277.2001.tb00031.x

Intrahepatic biliary lesions (IBL) are rare (2–9%) after orthotopic liver transplantation (OLT). The aim was to evaluate the incidence, etiology and outcome. In nine years, a total 532 OLTs were performed in 481 patients. Twenty‐four patients developed IBL. Eight were due to HAT, seven to ABOI, three to CDR and six to PI. The time until diagnosis of HAT is longest in patients (14 ± 6) with IBL. ABOI is another cause of IBL. CDR is a rare cause of IBL, however when it takes place, patients must undergo Rtx. Finally, PI is a relevant cause of IBL. In order to suppress the incidence of IBL we should consider 1) the systematic use of Doppler‐Ultrasound; 2) emergency reoperation of patients with HAT, 3) avoid ABOI in OLT; 4) Rtx in cases of CDR, and 5) OLT should still be performed as an emergency procedure.