Biliary strictures in pediatric liver transplant recipients - Early diagnosis and treatment results in excellent graft outcomes

Christopher D. Anderson, Yumirle P. Turmelle, Michael Darcy, Ross W. Shepherd, Alexander Weymann, Michelle Nadler, Sandra Guelker, William C. Chapman, Jeffrey A. Lowell

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Biliary complications in pediatric LT are important causes of morbidity and graft loss. We examined our recent pediatric LT experience to determine the outcome of post-LT biliary complications and their relationship to graft type. All initially isolated LTs performed at our institution between January 1, 2000 and August 20, 2007 were reviewed. Recipient data, donor type, graft survival, and biliary complications data were examined. Of 66 LTs, 32 patients received whole organ grafts, and 34 received partial grafts; 11 split, seven reduced size, and 16 live donors. Seventy-seven percent of patients had biliary reconstruction using a RYH. Overall, 17 (26%) developed biliary complications, and 15 were diagnosed within six months post-LT. Live donor and split allografts had more biliary complications than reduced size or whole allografts (50% and 36% vs. 0% and 16%, respectively). Seventy-one percent responded to percutaneous or endoscopic treatment. Five failed initial non-operative management and required reoperation (one retransplantation). These data suggest that biliary strictures occur most frequently in live donor and split allografts and that non-operative therapy is highly successful. Partial grafts are essential in pediatric LT, and a high clinical suspicion for biliary complications combined with aggressive and early diagnosis and therapy rarely results in graft loss.

Original languageEnglish
Pages (from-to)358-363
Number of pages6
JournalPediatric transplantation
Volume14
Issue number3
DOIs
StatePublished - May 2010

Keywords

  • Biliary strictures
  • Pediatric liver transplant
  • Split liver transplant

Fingerprint Dive into the research topics of 'Biliary strictures in pediatric liver transplant recipients - Early diagnosis and treatment results in excellent graft outcomes'. Together they form a unique fingerprint.

  • Cite this