Risk factors for biliary stricture and prognosis after orthotopic liver transplantation

Decai KONG; Xiaojing ZHANG; Yangguang YUN; Haoyu DUAN; Junfeng YE

doi:10.12449/JCH241119

Volume 40 Issue 11

Nov. 2024

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2024 > 40(11): 2253-2259

PDF( 861 KB)

Risk factors for biliary stricture and prognosis after orthotopic liver transplantation

DOI: 10.12449/JCH241119

First Department of Hepatobiliary and Pancreatic Surgery，General Surgery Center，The First Hospital of Jilin University，Changchun 130021，China

Research funding:

Jilin Province Medical and Health Talents Special Project (JLSWSRCZX2021-074)

More Information

Corresponding author: YE Junfeng， yejunfeng@jlu.edu.cn （ORCID： 0000-0001-5330-9712）
Received Date: 2024-02-22
Accepted Date: 2024-04-08
Published Date: 2024-11-25

Abstract

Abstract

Objective To investigate the risk factors for biliary stricture within two years after orthotopic liver transplantation， and analyze the survival. Methods A retrospective analysis was performed for the data of 495 patients who underwent liver transplantation at Liver Transplantation Center of The First Hospital of Jilin University from January 2014 to January 2022， and according to the presence or absence of biliary stricture within two years after liver transplantation， the 495 patients were divided into stricture group with 89 patients and non-stricture group with 406 patients. The risk factors for biliary stricture and prognosis were analyzed. The independent-samples t-test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Cox regression analyses were used for the analysis of risk factors， and the Kaplan-Meier method was used for survival analysis. Results Recipient sex （hazard ratio ［HR］=1.808， 95% confidence interval ［CI］： 1.055‍ ‍—‍ ‍3.098， P=0.031）， preoperative total bilirubin of the recipient （HR=1.002， 95%CI： 1.001 ‍—‍ 1.003， P=0.001）， cold ischemia time （HR=1.003， 95%CI： 1.001 ‍—‍ 1.005， P=0.007）， history of abdominal surgery for the recipient （HR=3.851， 95%CI： 2.273 ‍—‍ 6.524， P<0.001）， and mismatch of donor-recipient bile ducts （HR=1.962， 95%CI： 1.041 ‍—‍ 3.698， P=0.037） were identified as independent risk factors for biliary stricture within two years after transplantation. The median follow-up time was 4.09 years， and the 1-， 3-， and 5-year survival rates were 92.7%， 80.5%， and 75.4%， respectively， after liver transplantation. The onset of biliary stricture within two years after liver transplantation had no significant impact on the survival of patients undergoing orthotopic liver transplantation. Conclusion Recipient sex， preoperative total bilirubin of the recipient， cold ischemia time， history of abdominal surgery for the recipient， and mismatch of donor-recipient bile ducts are independent risk factors for biliary stricture within two years after transplantation. The onset of biliary stricture within two years after transplantation does not affect the survival time of patients undergoing orthotopic liver transplantation.
- Liver Transplantation,
- Biliary Stricture,
- Risk Factors,
- Prognosis

FullText(HTML)

References(25)

References

[1]	HIBI T, WEI CHIEH AK, CHI-YAN CHAN A, et al. Current status of liver transplantation in Asia[J]. Int J Surg, 2020, 82S: 4- 8. DOI: 10.1016/j.ijsu.2020.05.071.
[2]	MOY BT, BIRK JW. A review on the management of biliary complications after orthotopic liver transplantation[J]. J Clin Transl Hepatol, 2019, 7( 1): 61- 71. DOI: 10.14218/JCTH.2018.00028.
[3]	COTÉ GA, SLIVKA A, TARNASKY P, et al. Effect of covered metallic stents compared with plastic stents on benign biliary stricture resolution: A randomized clinical trial[J]. JAMA, 2016, 315( 12): 1250- 1257. DOI: 10.1001/jama.2016.2619.
[4]	AMATEAU SK, KOHLI DR, DESAI M, et al. American Society for Gastrointestinal Endoscopy guideline on management of post-liver transplant biliary strictures: Methodology and review of evidence[J]. Gastrointest Endosc, 2023, 97( 4): 615- 637. e 11. DOI: 10.1016/j.gie.2022.10.006.
[5]	FENG YJ, LI JD, LI Q, et al. Progress in diagnosis and treatment of biliary anastomotic stricture after liver transplantation[J]. Organ Transplant, 2024, 15( 2): 297- 302. DOI: 10.3969/j.issn.1674-7445.2023240. 冯彦杰, 李敬东, 李强, 等. 肝移植术后胆道吻合口狭窄的诊疗进展[J]. 器官移植, 2024, 15( 2): 297- 302. DOI: 10.3969/j.issn.1674-7445.2023240.
[6]	RAMMOHAN A, GOVIL S, VARGESE J, et al. Changing pattern of biliary complications in an evolving liver transplant unit[J]. Liver Transpl, 2017, 23( 4): 478- 486. DOI: 10.1002/lt.24736.
[7]	MAZILESCU LI, BERNHEIM I, TRECKMANN J, et al. Donor, recipient and surgeon sex and sex-concordance and their impact on liver transplant outcome[J]. J Pers Med, 2023, 13( 2): 281. DOI: 10.3390/jpm13020281.
[8]	LEGAZ I, NAVARRO NOGUERA E, BOLARÍN JM, et al. Patient sex in the setting of liver transplant in alcoholic liver disease[J]. Exp Clin Transplant, 2019, 17( 3): 355- 362. DOI: 10.6002/ect.2017.0302.
[9]	MAGRO B, TACELLI M, MAZZOLA A, et al. Biliary complications after liver transplantation: Current perspectives and future strategies[J]. Hepatobiliary Surg Nutr, 2021, 10( 1): 76- 92. DOI: 10.21037/hbsn.2019.09.01.
[10]	PENG T, ZHONG YL, LIN XD, et al. Analysis and numerical investigation of bile flow dynamics within the strictured biliary duct[J]. Int J Numer Method Biomed Eng, 2024, 40( 2): e3790. DOI: 10.1002/cnm.3790.
[11]	NEMES B, GÁMÁN G, DOROS A. Biliary complications after liver transplantation[J]. Expert Rev Gastroenterol Hepatol, 2015, 9( 4): 447- 466. DOI: 10.1586/17474124.2015.967761.
[12]	KALDAS FM, KORAYEM IM, RUSSELL TA, et al. Assessment of anastomotic biliary complications in adult patients undergoing high-acuity liver transplant[J]. JAMA Surg, 2019, 154( 5): 431- 439. DOI: 10.1001/jamasurg.2018.5527.
[13]	SUNDARAM V, JONES DT, SHAH NH, et al. Posttransplant biliary complications in the pre- and post-model for end-stage liver disease era[J]. Liver Transpl, 2011, 17( 4): 428- 435. DOI: 10.1002/lt.22251.
[14]	KEANE MG, DEVLIN J, HARRISON P, et al. Diagnosis and management of benign biliary strictures post liver transplantation in adults[J]. Transplant Rev, 2021, 35( 1): 100593. DOI: 10.1016/j.trre.2020.100593.
[15]	LIU DQ, SUN XD, QIU W, et al. Analysis of influencing factors for anastomotic biliary stricture after liver transplantation[J]. Chin J Dig Surg, 2022, 21( 2): 249- 255. DOI: 10.3760/cma.j.cn115610-20211129-00602. 刘大群, 孙晓东, 邱伟, 等. 影响肝移植术后胆管吻合口狭窄的相关因素分析[J]. 中华消化外科杂志, 2022, 21( 2): 249- 255. DOI: 10.3760/cma.j.cn115610-20211129-00602.
[16]	FASULLO M, SHAH T, ZHOU HP, et al. Post-transplant biliary strictures: An updated review[J]. Semin Liver Dis, 2022, 42( 2): 225- 232. DOI: 10.1055/s-0042-1744144.
[17]	VRIES YD, von MEIJENFELDT FA, PORTE RJ. Post-transplant cholangiopathy: Classification, pathogenesis, and preventive strategies[J]. Biochim Biophys Acta Mol Basis Dis, 2018, 1864( 4 Pt B): 1507- 1515. DOI: 10.1016/j.bbadis.2017.06.013.
[18]	HU XW, LI T. Diagnosis and treatment of common biliary complications after orthotopic liver transplantation in adults[J]. Organ Transplant, 2022, 13( 5): 569- 576. DOI: 10.3969/j.issn.1674-7445.2022.05.004. 胡鑫文, 李亭. 成人原位肝移植术后常见胆道并发症的诊疗[J]. 器官移植, 2022, 13( 5): 569- 576. DOI: 10.3969/j.issn.1674-7445.2022.05.004.
[19]	PARENTE A, TIROTTA F, PINI A, et al. Machine perfusion techniques for liver transplantation- A meta-analysis of the first seven randomized-controlled trials[J]. J Hepatol, 2023, 79( 5): 1201- 1213. DOI: 10.1016/j.jhep.2023.05.027.
[20]	AGOPIAN VG, PETROWSKY H, KALDAS FM, et al. The evolution of liver transplantation during 3 decades: Analysis of 5347 consecutive liver transplants at a single center[J]. Ann Surg, 2013, 258( 3): 409- 421. DOI: 10.1097/SLA.0b013e3182a15db4.
[21]	SENTER-ZAPATA M, KHAN AS, SUBRAMANIAN T, et al. Patient and graft survival: Biliary complications after liver transplantation[J]. J Am Coll Surg, 2018, 226( 4): 484- 494. DOI: 10.1016/j.jamcollsurg.2017.12.039.
[22]	JARLOT-GAS C, MUSCARI F, MOKRANE FZ, et al. Management of anastomotic biliary stricture after liver transplantation and impact on survival[J]. HPB, 2021, 23( 8): 1259- 1268. DOI: 10.1016/j.hpb.2020.12.008.
[23]	MATAR AJ, ROSS-DRISCOLL K, KENNEY L, et al. Biliary complications following adult deceased donor liver transplantation: Risk factors and implications at a high-volume US center[J]. Transplant Direct, 2021, 7( 10): e754. DOI: 10.1097/TXD.0000000000001207.
[24]	AXELROD DA, LENTINE KL, XIAO HL, et al. National assessment of early biliary complications following liver transplantation: Incidence and outcomes[J]. Liver Transpl, 2014, 20( 4): 446- 456. DOI: 10.1002/lt.23829.
[25]	ZHANG CC, RUPP C, EXARCHOS X, et al. Scheduled endoscopic treatment of biliary anastomotic and nonanastomotic strictures after orthotopic liver transplantation[J]. Gastrointest Endosc, 2023, 97( 1): 42- 49. DOI: 10.1016/j.gie.2022.08.034.

Relative Articles

[1]	Bingbing ZHU, Jinxiang YANG, Qun ZHANG, Fangyuan GAO, Xianbo WANG. Risk factors for the 90-day prognosis of patients with type I hepatorenal syndrome and establishment of a predictive model[J]. Journal of Clinical Hepatology, 2022, 38(7): 1561-1565. doi: 10.3969/j.issn.1001-5256.2022.07.019
[2]	Wanshu LIU, Lijun SHEN, Qinghui ZHAI, Shaojie XIN, Shaoli YOU. Risk factors for acute variceal bleeding in acute-on-chronic liver failure and its influence on prognosis[J]. Journal of Clinical Hepatology, 2022, 38(11): 2532-2536. doi: 10.3969/j.issn.1001-5256.2022.11.018
[3]	Siqin LIU, Xiaomei WANG, Xia LI, Luwen LIANG, Ke WANG, Rui WANG. Covert hepatic encephalopathy in liver cirrhosis: Risk factors and prognosis[J]. Journal of Clinical Hepatology, 2022, 38(2): 359-364. doi: 10.3969/j.issn.1001-5256.2022.02.020
[4]	Ping ZHU, Heping ZHAO, Tao HAN, Qing YE, Tinghong LI, Huiling XIANG. Evaluation and influencing factors of the short-term prognosis of severe alcoholic hepatitis with different underlying liver diseases[J]. Journal of Clinical Hepatology, 2021, 37(2): 370-374. doi: 10.3969/j.issn.1001-5256.2021.02.024
[5]	Yun ZHAO, Lijin ZHAO. Research advances in the risk factors for infection after liver transplantation[J]. Journal of Clinical Hepatology, 2021, 37(8): 1957-1962. doi: 10.3969/j.issn.1001-5256.2021.08.046
[6]	Wang Han, Zuo XiangRong, Cao Quan. Predictive factors and interventions for prolonged mechanical ventilation after liver transplantation[J]. Journal of Clinical Hepatology, 2020, 36(7): 1658-1662. doi: 10.3969/j.issn.1001-5256.2020.07.047
[7]	Zhang DaLi, Feng DanNi, Zhang LiJuan, Tang RuJia, He Xi, Zhou Xia, Gao YinJie, Liu ZhenWen, Liu HongLing. Risk factors for recurrence after liver transplantation in patients with hepatocellular carcinoma and their prognosis[J]. Journal of Clinical Hepatology, 2020, 36(9): 1985-1989. doi: 10.3969/j.issn.1001-5256.2020.09.015
[8]	Zheng WeiPing, Shen ZhongYang. Risk factors for tumor recurrence after liver transplantation for hepatocellular carcinoma and related control strategies[J]. Journal of Clinical Hepatology, 2019, 35(11): 2391-2395. doi: 10.3969/j.issn.1001-5256.2019.11.003
[9]	Jie EnBo, Xuan FengHui, Sun XiaoDong, Sun DaWei, Lu: GuoYue. An analysis of risk factors for early complications after liver transplantation[J]. Journal of Clinical Hepatology, 2018, 34(6): 1282-1288. doi: 10.3969/j.issn.1001-5256.2018.06.030
[10]	Li Ying, Zhan Jing, Wang ZhongFeng. Prognostic factors for patients with hepatitis B virus-related acute-on-chronic liver failure[J]. Journal of Clinical Hepatology, 2017, 33(3): 497-501. doi: 10.3969/j.issn.1001-5256.2017.03.020
[11]	Wang FengJiao, Liu MingJiang, Wu RuiHong, Niu JunQi. A multivariate logistic regression analysis of short-term prognosis of patients with hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2017, 33(4): 711-714. doi: 10.3969/j.issn.1001-5256.2017.04.022
[12]	Cui YanPing, Li QingFang, Li QingYan, Liu ChunHua, Wang WeiHong, Yuan JianGuo, Wang SiKui. Logistic regression analysis of prognostic risk factors for hepatic encephalopathy[J]. Journal of Clinical Hepatology, 2016, 32(1): 135-138. doi: 10.3969/j.issn.1001-5256.2016.01.026
[13]	Shi XinXing, Zhang YanQiong, Zhu Peng, Yan GuoHua, Zhang ZhangJiang, Wang YuMing. Prognostic risk factors in patients with hepatitis B virus- related acute- on- chronic liver failure[J]. Journal of Clinical Hepatology, 2016, 32(4): 700-705. doi: 10.3969/j.issn.1001-5256.2016.04.018
[14]	Lu: GuoYue. Risk factors for biliary complications after liver transplantation from donation after cardiac death[J]. Journal of Clinical Hepatology, 2015, 31(12): 2027-2030. doi: 10.3969/j.issn.1001-5256.2015.12.009
[15]	Wu XiaoFeng, Lin DongDong. Analysis of risk factors for non-anastomotic biliary stricture following liver transplantation[J]. Journal of Clinical Hepatology, 2013, 29(6): 424-426.
[16]	Wu XiaoQing, Wan Hong. Causes of liver failure and impact analysis of prognostic risk factors[J]. Journal of Clinical Hepatology, 2013, 29(4): 294-296+304.
[17]	Zhang DongQing, Chen Li, Gan QiaoRong, Zhou Rui, Huang JianRong, Pan Chen. Prognostic factors for hepatitis B acute-on-chronic liver failure[J]. Journal of Clinical Hepatology, 2012, 28(10): 740-743.
[18]	Liu HongHong, Fu JunLiang, Fu BaoYun, Zhang Zheng, Xu RuoNan, Luo ShengQiang, Shi Ming, Li YongGang, Wang FuSheng. The pathogenesis and risk factors related to prognosis of primary biliary cirrhosis[J]. Journal of Clinical Hepatology, 2012, 28(2): 153-155.
[19]	Lu: RiYing, Li ShiXiong, Wu JiZhou, Zhu YuJia, Fu ShaoPing. Development of a prognostic factors model for severe hepatitis[J]. Journal of Clinical Hepatology, 2012, 28(10): 789-792.
[20]	Ding HuiGuo, Gao GuiJu, Chen Tao, Jin Rui. Prognosis of Severe Types of Virous Hepatitis: Study on Mutiple Risk Factors.[J]. Journal of Clinical Hepatology, 2002, 18(5): 297-299.

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(4) / Tables(4)

Get Citation

PDF

XML

Article Metrics

Article views (221) PDF downloads(36)

Risk factors for biliary stricture and prognosis after orthotopic liver transplantation

DOI: 10.12449/JCH241119

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Risk factors for biliary stricture and prognosis after orthotopic liver transplantation

DOI: 10.12449/JCH241119

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content