Ultrasound-Based Multimodal Imaging Predicting Ischemic-Type Biliary Lesions After Living-Donor Liver Transplantation

• Published in: International journal of general medicine Vol. 14; pp. 1599 - 1609
• Main Authors: Liu, Jin-Qiao, Chen, Wen-Juan, Zhou, Meng-Jie, Li, Wen-Feng, Tang, Ju
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Bile; biliary atresia; Calibration; Children; color doppler flow imaging; Donation of organs, tissues, etc; Health aspects; Ischemia; ischemic-type biliary lesions; Liver; liver stiffness measurement; Liver transplants; living-donor liver transplantation; Medical prognosis; Nomograms; Original Research; Patients; pediatric patients; Pediatrics; Thrombosis; Transplantation of organs, tissues, etc; Ultrasonic imaging; Veins & arteries; China; biliary atresia; ischemic-type biliary lesions; liver stiffness measurement; living-donor liver transplantation; color Doppler flow imaging; pediatric patients
• ISSN: 1178-7074; 1178-7074
• DOI: 10.2147/IJGM.S305827

Ischemic-type biliary lesions (ITBL) are accepted as the most incomprehensible biliary complications after living-donor liver transplantation (LDLT). Early predicting the development of ITBL in pediatric patients permits more preventive strategies. However, few studies have focused on the early prediction of ITBL. This study aimed to establish a nomogram including ultrasound-based multimodal imaging to predict ITBL in children with biliary atresia (BA) within 2 years after receiving LDLT. The records of 94 BA children with at least one year of follow-up after LDLT were reviewed retrospectively. They were randomly divided into a training cohort for constructing a nomogram (n=64) and a validation cohort (n=30). In the training cohort, patients diagnosed as ITBL were included in the ITBL group and those without any vascular and biliary complication were included in the non-ITBL group. Multivariate Cox regression was used for the establishment of the nomogram in predicting the risk of ITBL within 2 years post-LDLT. The discrimination and calibration of the nomogram were internally and externally validated. The performances of the nomogram and the individual components were compared by the area under the curve (AUC) of receiver operating characteristic (ROC) curve. In the training cohort, 18 BA children were included in the ITBL group and 46 were in the non-ITBL group. Last pediatric end-stage liver disease (PELD) score, gamma-glutamyl transpeptidase (GGT), resistive index (RI), and liver stiffness measurement (LSM) were the independent predictors for the development of ITBL within 2 years post-LDLT. The nomogram incorporating these independent predictors showed good discrimination and calibration by the internal and external validation. Its performance was better than any individual component in predicting the prognosis ( < 0.05). The established nomogram may be used to predict the risk of ITBL within 2 years post-LDLT in BA children.