Impact of non‐anastomotic biliary strictures after liver transplantation on healthcare consumption, use of ionizing radiation and infectious events. Issue 1 (9th December 2015)

• Record Type: Journal Article
• Authors: de Vries, A. Boudewijn; Koornstra, Jan J.; Lo Ten Foe, Jerome R.; Porte, Robert J.; van den Berg, Aad P.; Blokzijl, Hans; Verdonk, Robert C.
• Is Part Of: Clinical transplantation. Volume 30:Issue 1(2016)
• Page Start: 81
• Page End: 89
• Publication Date: 2015-12-09
• Subjects: biliary complications -- health care consumption -- highly resistant microorganisms -- infectious complications -- interventional procedures -- ionizing radiation -- ischemic type biliary lesions -- liver transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12664
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: Non‐anastomotic biliary strictures (NAS) after orthotopic liver transplantation (OLT) have a negative influence on graft survival. Expert opinion suggests a negative effect of NAS on other important aspects of post‐transplant care, although its impact is largely unknown as data are scarce. Methods: This retrospective single center study analyzed data on healthcare consumption, use of ionizing radiation, infectious complications and development of highly resistant microorganisms (HRMO) in adult patients with NAS. A comparison with a matched control group was made. Results: Forty‐three liver recipients with NAS and 43 controls were included. Hospital admissions were higher in patients with NAS. Most common reason for admission was bacterial cholangitis (BC), with 70% of the patients having at least one episode compared to 9% in the control group. In patients with NAS, 67% received at least one ERCP compared to 21% in the control group (p = 0.001). This resulted in a larger yearly received radiation dose for patients with NAS (p = 0.001). Frequency of intravenous antibiotic therapy was higher (p = 0.001) for patients with NAS, consistently resulting in a higher number of cultures found with HRMO (p = 0.012). Conclusion: NAS after OLT have a negative effect on post‐transplant care, increasing readmission rates, interventional procedures, exposure to ionizing radiation, use of antibiotics, and development of HRMO.