Clinical Analysis of Classification and Prognosis of Ischemia-Type Biliary Lesions After Liver Transplantation
Rui Shi, Tong Liu, Zirong Liu, Yamin Zhang, Zhongyang Shen
(Organ Transplantation Center, The First Central Hospital of Tianjin, Tianjin, China (mainland))
Ann Transplant 2018; 23:190-196
The aim of this study was to classify ischemia-type biliary lesions after liver transplantation according to their imaging findings and severity of clinical manifestations and to analyze the relationship between such classification and prognosis.
MATERIAL AND METHODS: We collected clinical data of patients with ischemia-type biliary lesions (ITBL) after liver transplantation in the Organ Transplantation Center, the First Central Hospital of Tianjin, from August 2012 to July 2013; all patients were classified according to their imaging findings and relevant clinical data to analyze the relationship between their classification and prognosis.
RESULTS: The mean postoperative survival time, as well as the 1-, 3-, and 5-year survival rate, in Group ITBL showed statistical significance when compared with those in Group NITBL (log rank=12.13, P<0.001), but the mean postoperative survival times among the mild, moderate, and severe ITBL cases showed no statistical significance. The incidence rates of 1-, 3-, and 5-year adverse prognosis in Group ITBL showed statistical significance when compared with Group NITBL with <2% patients who had anastomotic biliary obstruction (log rank=277.06, P<0.001), among which the difference in the incidence rate of adverse prognosis between severe and moderate ITBL cases showed no statistical significance. The difference in the incidence rate of adverse prognosis between mild and moderate ITBL cases showed statistical significance (log rank=6.01, P=0.014), and the difference in the incidence rate of adverse prognosis between mild and severe ITBL cases showed statistical significance (log rank=10.98, P=0.001).
CONCLUSIONS: ITBL classification based on the severity of biliary imaging and bilirubin level can predict the prognosis of ITBL.
Keywords: Liver Transplantation, Prognosis, Statistics as Topic, Transplantation, Homologous