American Journal of Roentgenology, Vol 161, 297-300, Copyright © 1993 by American Roentgen Ray Society
Biliary strictures in hepatic transplants: prevalence and types in patients with primary sclerosing cholangitis vs those with other liver diseases
R Sheng, AB Zajko, WL Campbell and K Abu-Elmagd
Department of Radiology, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, PA 15213.
OBJECTIVE. The purpose of this study was to determine the prevalence and
types of biliary strictures seen in liver allografts transplanted for
primary sclerosing cholangitis and other end-stage liver diseases and to
determine if such strictures occur more often in the allografts
transplanted for primary sclerosing cholangitis than in the others.
MATERIALS AND METHODS. During a 10-year period, 643 liver transplantation
patients (687 allografts) with choledochojejunostomy biliary anastomoses
underwent 1728 cholangiographic studies. Three hundred six cholangiograms
were obtained in 100 transplant recipients who had primary sclerosing
cholangitis (112 allografts) and 1422 cholangiograms were obtained in 543
recipients who had other liver diseases (575 allografts). We
retrospectively reviewed all cholangiograms of transplant recipients who
had primary sclerosing cholangitis and 909 cholangiograms of the recipients
who had other liver diseases and a diagnosis of biliary strictures,
possible biliary strictures, or duct irregularity based on radiologic
reports. The presence, number, and locations of strictures were recorded.
The remaining 513 cholangiograms of recipients with other liver diseases
without strictures were not reviewed. Biliary strictures were classified as
intrahepatic (including bifurcation), anastomotic, and nonanastomotic
extrahepatic. RESULTS. Cholangiograms showed intrahepatic biliary
strictures in 105 allografts (15%), anastomotic strictures in 105
allografts (15%), and nonanastomotic extrahepatic biliary strictures in 17
allografts (2%). Intrahepatic biliary strictures were diagnosed in 27%
(30/112) of the allografts transplanted for primary sclerosing cholangitis
and in 13% (75/575) of the allografts transplanted for other end-stage
liver diseases (p = .0005). Anastomotic strictures developed in 18%
(20/112) of the allografts transplanted for primary sclerosing cholangitis
and in 15% (85/575) of the others (p = .381). Nonanastomotic extrahepatic
strictures were seen in 6% (7/112) of the allografts transplanted for
primary sclerosing cholangitis and in 2% (10/575) of the others (p = .008).
CONCLUSION. Intrahepatic and nonanastomotic extrahepatic biliary strictures
are significantly more common in patients who have liver transplantation
for primary sclerosing cholangitis than in patients who receive allografts
for other end-stage liver diseases. However, strictures at the
choledochojejunostomy anastomosis occur with equal frequency in both groups
of patients.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
