ISCHEMIC-TYPE BILIARY COMPLICATIONS AFTER ORTHOTOPIC LIVER-TRANSPLANTATION
ISCHEMIC-TYPE BILIARY COMPLICATIONS AFTER ORTHOTOPIC LIVER-TRANSPLANTATION
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DOI：
10.1002/hep.1840160110
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发表时间：
1992-07-01
期刊：
影响因子：
13.5
通讯作者：
KROM, RAF
中科院分区：
文献类型：
--
作者：
SANCHEZURDAZPAL, L;GORES, GJ;KROM, RAF
肝动脉血栓形成、慢性导管减少性排斥反应和ABO血型不相容的患者在原位肝移植后发生仅涉及移植物胆道的非吻合性胆道狭窄。这种并发症也可能发生在没有这些已知危险因素的情况下。本研究的主要重点是评估原位肝移植术后不明原因非吻合口胆道狭窄的危险因素。结果表明，胆道狭窄的发展与同种异体移植物在Euro-Collins溶液和University of Wisconsin溶液中的冷缺血储存时间密切相关。结果还表明，狭窄与胆道重建类型、原发性肝病、巨细胞病毒感染、同种异体移植排斥反应或淋巴细胞毒性交叉配型阳性无关。最近，我们通过减少同种异体移植的缺血时间，显著减少了非吻合口胆道狭窄的发生。因此，非吻合性胆道狭窄似乎是与同种异体移植相关的缺血/再灌注诱导的组织损伤的结果。
Nonanastomotic biliary strictures that involve only the biliary tree of the graft occur after orthotopic liver transplantation in patients with hepatic artery thrombosis, chronic ductopenic rejection and ABO blood group incompatibility. This complication may also occur in the absence of these known risk factors. The major focus of our study was to evaluate the risk factors for nonanastomotic biliary stricturing of unknown cause after orthotopic liver transplantation. Results demonstrate that the development of biliary strictures is strongly associated with the duration of cold ischemic storage of allografts in both Euro-Collins solution and University of Wisconsin solution. Results also demonstrate that strictures are not associated with the type of biliary reconstruction, the primary liver disease, cytomegalovirus infection, allograft rejection or the presence of a positive lymphocytotoxic crossmatch. More recently, we have markedly reduced the occurrence of nonanastomotic biliary stricturing by decreasing the ischemia time of our allografts. Thus nonanastomotic biliary strictures appear to be the result of the ischemia/reperfusion-induced tissue injury associated with the harvest and implantation of allografts.