Recipient-associated risk factors for post-liver transplantation biliary complications: A cohort study.

INTRODUCTION: Biliary complications (BCs) are a well-documented post-liver transplantation concern with potential implications for patient survival. This study aims at identifying risk factors associated with the development of BCs in recipients after liver transplantation (LT) and exploring strategies for their management. METHODS: We conducted a retrospective analysis of 1595 adult patients (age > 18 years) who underwent LT surgery between 2019 and 2021. The study assessed the incidence of BCs in this cohort. RESULTS: Of 1595 patients, 178 (11.1%) experienced BCs, while 1417 (88.8%) did not exhibit any signs of such complications. Patients who developed BCs were found to have a significantly lower average age (p < 0.001) and longer cold ischemic times (p < 0.001) compared to those without BCs. Variables such as sex, body mass index (BMI), model for end-stage liver disease (MELD) score, primary diagnosis, type of anastomosis, hepatectomy technique, type of transplanted liver and mortality did not demonstrate statistically significant differences between the two groups (p > 0.05). Univariate logistic regression analysis revealed that a cold ischemic time exceeding 12 hours and duct-to-duct anastomosis were positive predictors for BC development (odds ratios of 6.23 [CI 4.29-9.02] and 1.47 [CI 0.94-2.30], respectively). Conversely, increasing age was associated with a protective effect against BC development, with an odds ratio of 0.64 (CI 0.46-0.89). CONCLUSION: Our multi-variate analysis identified cold ischemia time (CIT) as the sole significant predictor of post-liver transplantation biliary complications. Additionally, this study observed that advancing patient age had a protective influence in this context. Notably, no significant disparities were detected between hepatectomy techniques and the etiology of liver disease types in the two study groups.

The role of antral histopathology in diagnosing paediatric celiac disease.

The aim of this study was to evaluate the diagnostic potential of gastric antrum histology in children suspected of having celiac disease (CD). The present retrospective study was performed on 224 patients who were suspected of having CD and had several duodenal and one gastric antrum biopsies. They were divided into 2 groups based on the definite diagnosis of CD. The statistical analysis was performed using SPSS version 22 software. Receiver operating characteristic (ROC) curves were drown and the area under the curves (AUCs) was calculated. Article authorized by the Editor-in-Chief. Based on MARSH criteria, out of 224 patients, 124 were diagnosed as definite CD and 100 patients comprised the non-celiac group. The AUC for the mean of all pathological tests was estimated to be 0.90 (p < 0.001). The pooled AUC for the combination of 3 pathologic findings with the highest AUCs (cell, crypt, and gland size) was estimated to be 0.89 (p < 0.001). We observed that the histological changes we found in the gastric antrum were identical to those found in the duodenum of paediatric CD patients. Because providing a biopsy from the gastric antrum is easier than getting multiple biopsies from the duodenum, we suggest using the criteria mentioned in this study in other studies with larger sample sizes.