Biliary Strictures Are Associated With Both Early and Late Hepatic Artery Stenosis

Angus Hann; Rashmi Seth; Hynek Mergental; Hermien Hartog; Mohammad Alzoubi; Arie Stangou; Omar El-Sherif; James Ferguson; Keith Roberts; Paolo Muiesan; Ye Oo; John R Issac; Darius Mirza; M Thamara P R Perera

doi:10.1097/TXD.0000000000001092

Biliary Strictures Are Associated With Both Early and Late Hepatic Artery Stenosis

Angus Hann, Rashmi Seth, Hynek Mergental, Hermien Hartog, Mohammad Alzoubi, Arie Stangou, Omar El-Sherif, James Ferguson, Keith Roberts, Paolo Muiesan, Ye Oo, John R Issac, Darius Mirza, M Thamara P R Perera

Immunology and Immunotherapy

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Abstract

Background: Hepatic artery stenosis (HAS) following liver transplantation results in hypoperfusion and ischemic damage to the biliary tree. This study aimed to investigate how vascular intervention, liver function test derangement, and time point of HAS onset influence biliary complications.

Methods: A single-center retrospective study of adult patients that underwent primary liver transplantation. Patients were grouped according to the presence or absence of HAS and then into early (≤90 d) or late (>90 d) subgroups. Biliary complications comprised anastomotic (AS) or non ASs (NASs).

Results: Computed tomography angiography confirmed HAS was present in 39 of 1232 patients (3.2%). This occurred at ≤90 and >90 days in 20 (1.6%) and 19 (1.5%), respectively. The incidence of biliary strictures (BSs) in the group with HAS was higher than the group without (13/39; 33% versus 85/1193; 7.1%, P = 0.01). BS occurred in 8/20 (40.0%) and 5/19 (26.3%) of the early and late groups, respectively. The need for biliary intervention increased if any liver function test result was ≥3× upper limit of normal (P = 0.019).

Conclusions: BS occurs at a significantly higher rate in the presence of HAS. Onset of HAS at ≤90 or ≥90 days can both be associated with morbidity. Significant liver function test derangement at HAS diagnosis indicates a higher likelihood of biliary intervention for strictures.

Original language	English
Article number	e643
Journal	Transplantation direct
Volume	7
Issue number	1
DOIs	https://doi.org/10.1097/TXD.0000000000001092
Publication status	Published - 15 Jan 2021

ASJC Scopus subject areas

Transplantation

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@article{cd4285e42b1946cabe4127e1a3fe7f5a,

title = "Biliary Strictures Are Associated With Both Early and Late Hepatic Artery Stenosis",

abstract = "Background: Hepatic artery stenosis (HAS) following liver transplantation results in hypoperfusion and ischemic damage to the biliary tree. This study aimed to investigate how vascular intervention, liver function test derangement, and time point of HAS onset influence biliary complications.Methods: A single-center retrospective study of adult patients that underwent primary liver transplantation. Patients were grouped according to the presence or absence of HAS and then into early (≤90 d) or late (>90 d) subgroups. Biliary complications comprised anastomotic (AS) or non ASs (NASs).Results: Computed tomography angiography confirmed HAS was present in 39 of 1232 patients (3.2%). This occurred at ≤90 and >90 days in 20 (1.6%) and 19 (1.5%), respectively. The incidence of biliary strictures (BSs) in the group with HAS was higher than the group without (13/39; 33% versus 85/1193; 7.1%, P = 0.01). BS occurred in 8/20 (40.0%) and 5/19 (26.3%) of the early and late groups, respectively. The need for biliary intervention increased if any liver function test result was ≥3× upper limit of normal (P = 0.019).Conclusions: BS occurs at a significantly higher rate in the presence of HAS. Onset of HAS at ≤90 or ≥90 days can both be associated with morbidity. Significant liver function test derangement at HAS diagnosis indicates a higher likelihood of biliary intervention for strictures.",

author = "Angus Hann and Rashmi Seth and Hynek Mergental and Hermien Hartog and Mohammad Alzoubi and Arie Stangou and Omar El-Sherif and James Ferguson and Keith Roberts and Paolo Muiesan and Ye Oo and Issac, {John R} and Darius Mirza and Perera, {M Thamara P R}",

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year = "2021",

month = jan,

day = "15",

doi = "10.1097/TXD.0000000000001092",

language = "English",

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journal = "Transplantation direct",

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T1 - Biliary Strictures Are Associated With Both Early and Late Hepatic Artery Stenosis

AU - Hann, Angus

AU - Seth, Rashmi

AU - Mergental, Hynek

AU - Hartog, Hermien

AU - Alzoubi, Mohammad

AU - Stangou, Arie

AU - El-Sherif, Omar

AU - Ferguson, James

AU - Roberts, Keith

AU - Muiesan, Paolo

AU - Oo, Ye

AU - Issac, John R

AU - Mirza, Darius

AU - Perera, M Thamara P R

PY - 2021/1/15

Y1 - 2021/1/15

N2 - Background: Hepatic artery stenosis (HAS) following liver transplantation results in hypoperfusion and ischemic damage to the biliary tree. This study aimed to investigate how vascular intervention, liver function test derangement, and time point of HAS onset influence biliary complications.Methods: A single-center retrospective study of adult patients that underwent primary liver transplantation. Patients were grouped according to the presence or absence of HAS and then into early (≤90 d) or late (>90 d) subgroups. Biliary complications comprised anastomotic (AS) or non ASs (NASs).Results: Computed tomography angiography confirmed HAS was present in 39 of 1232 patients (3.2%). This occurred at ≤90 and >90 days in 20 (1.6%) and 19 (1.5%), respectively. The incidence of biliary strictures (BSs) in the group with HAS was higher than the group without (13/39; 33% versus 85/1193; 7.1%, P = 0.01). BS occurred in 8/20 (40.0%) and 5/19 (26.3%) of the early and late groups, respectively. The need for biliary intervention increased if any liver function test result was ≥3× upper limit of normal (P = 0.019).Conclusions: BS occurs at a significantly higher rate in the presence of HAS. Onset of HAS at ≤90 or ≥90 days can both be associated with morbidity. Significant liver function test derangement at HAS diagnosis indicates a higher likelihood of biliary intervention for strictures.

AB - Background: Hepatic artery stenosis (HAS) following liver transplantation results in hypoperfusion and ischemic damage to the biliary tree. This study aimed to investigate how vascular intervention, liver function test derangement, and time point of HAS onset influence biliary complications.Methods: A single-center retrospective study of adult patients that underwent primary liver transplantation. Patients were grouped according to the presence or absence of HAS and then into early (≤90 d) or late (>90 d) subgroups. Biliary complications comprised anastomotic (AS) or non ASs (NASs).Results: Computed tomography angiography confirmed HAS was present in 39 of 1232 patients (3.2%). This occurred at ≤90 and >90 days in 20 (1.6%) and 19 (1.5%), respectively. The incidence of biliary strictures (BSs) in the group with HAS was higher than the group without (13/39; 33% versus 85/1193; 7.1%, P = 0.01). BS occurred in 8/20 (40.0%) and 5/19 (26.3%) of the early and late groups, respectively. The need for biliary intervention increased if any liver function test result was ≥3× upper limit of normal (P = 0.019).Conclusions: BS occurs at a significantly higher rate in the presence of HAS. Onset of HAS at ≤90 or ≥90 days can both be associated with morbidity. Significant liver function test derangement at HAS diagnosis indicates a higher likelihood of biliary intervention for strictures.

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DO - 10.1097/TXD.0000000000001092

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C2 - 33335982

SN - 2373-8731

VL - 7

JO - Transplantation direct

JF - Transplantation direct

IS - 1

M1 - e643

ER -

Biliary Strictures Are Associated With Both Early and Late Hepatic Artery Stenosis

Abstract

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