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Clin Transplant ; 31(7)2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28489291

RESUMO

BACKGROUND: Endoscopic treatment of anastomotic biliary stricture (ABS) after liver transplantation (LT) has been proven to be effective and safe, but long-term outcomes of early compared to late onset ABS have not been studied. The aim of this study is to compare the long-term outcome of early ABS to late ABS. METHODS: Of the 806 adult LT recipients (04/2006-12/2012), 93 patients met the criteria for inclusion, and were grouped into non-ABS (no stenosis on ERCP, n=41), early ABS (stenosis <90 days after LT, 18 [19.3%]), and late ABS (stenosis ≥90 days after LT, 34 [36.5%]). A propensity matched control group for the ABS group (n=42) was obtained matched for outcome variables for age, gender, and calculated MELD score at listing. RESULTS: Mean number of ERCPs (2.33±1.3 vs 2.56±1.5, P=.69) were comparable between the groups; however, significantly better long-term resolution of the stricture was noted in the early ABS group (94.44% vs 67.65%, P=.04). Kaplan-Meier analysis revealed worst survival in the early ABS group compared to the non-ABS, late ABS, and control groups (P=.0001). CONCLUSION: LT recipients with early ABS have inferior graft survival despite better response to endoscopic intervention.


Assuntos
Anastomose Cirúrgica/mortalidade , Sistema Biliar/patologia , Colestase Extra-Hepática/mortalidade , Constrição Patológica/mortalidade , Rejeição de Enxerto/mortalidade , Transplante de Fígado/efeitos adversos , Complicações Pós-Operatórias/mortalidade , Adulto , Estudos de Casos e Controles , Colestase Extra-Hepática/etiologia , Colestase Extra-Hepática/terapia , Constrição Patológica/etiologia , Constrição Patológica/terapia , Feminino , Seguimentos , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/terapia , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Fatores de Tempo
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