Ultrasound-Based Multimodal Imaging Predicting Ischemic-Type Biliary Lesions After Living-Donor Liver Transplantation

Overview

Journal Int J Gen Med

Publisher Dove Medical Press

Specialty General Medicine

Date 2021 May 7

PMID 33958890

Citations 3

Authors

Jin-Qiao Liu

Wen-Juan Chen

Meng-Jie Zhou

Wen-Feng Li

Ju Tang

Affiliations

Soon will be listed here.

Abstract

Background: Ischemic-type biliary lesions (ITBL) are accepted as the most incomprehensible biliary complications after living-donor liver transplantation (LDLT). Early predicting the development of ITBL in pediatric patients permits more preventive strategies. However, few studies have focused on the early prediction of ITBL.

Objective: This study aimed to establish a nomogram including ultrasound-based multimodal imaging to predict ITBL in children with biliary atresia (BA) within 2 years after receiving LDLT.

Methods: The records of 94 BA children with at least one year of follow-up after LDLT were reviewed retrospectively. They were randomly divided into a training cohort for constructing a nomogram (n=64) and a validation cohort (n=30). In the training cohort, patients diagnosed as ITBL were included in the ITBL group and those without any vascular and biliary complication were included in the non-ITBL group. Multivariate Cox regression was used for the establishment of the nomogram in predicting the risk of ITBL within 2 years post-LDLT. The discrimination and calibration of the nomogram were internally and externally validated. The performances of the nomogram and the individual components were compared by the area under the curve (AUC) of receiver operating characteristic (ROC) curve.

Results: In the training cohort, 18 BA children were included in the ITBL group and 46 were in the non-ITBL group. Last pediatric end-stage liver disease (PELD) score, gamma-glutamyl transpeptidase (GGT), resistive index (RI), and liver stiffness measurement (LSM) were the independent predictors for the development of ITBL within 2 years post-LDLT. The nomogram incorporating these independent predictors showed good discrimination and calibration by the internal and external validation. Its performance was better than any individual component in predicting the prognosis ( < 0.05).

Conclusion: The established nomogram may be used to predict the risk of ITBL within 2 years post-LDLT in BA children.

Citing Articles

Prediction of early recovery of graft function after living donor liver transplantation in children.

Tan B, Yang C, Hu J, Xing H, Zhang M Sci Rep. 2024; 14(1):9472.

PMID: 38658800 PMC: 11043388. DOI: 10.1038/s41598-024-60211-6.

Artificial Intelligence Algorithm-Based CTA Imaging for Diagnosing Ischemic Type Biliary Lesions after Orthotopic Liver Transplantation.

Yu Z, Ou G, Wang R, Zhang Q Comput Math Methods Med. 2022; 2022:3399892.

PMID: 35027941 PMC: 8752212. DOI: 10.1155/2022/3399892.

Miniaturized optical fiber probe for prostate cancer screening.

Iele A, Ricciardi A, Pecorella C, Cirillo A, Ficuciello F, Siciliano B Biomed Opt Express. 2021; 12(9):5691-5703.

PMID: 34692209 PMC: 8515973. DOI: 10.1364/BOE.430408.

References

van Katwyk S, Coyle D, Cooper C, Pussegoda K, Cameron C, Skidmore B . Transient elastography for the diagnosis of liver fibrosis: a systematic review of economic evaluations. Liver Int. 2016; 37(6):851-861. DOI: 10.1111/liv.13260. View

Potthoff A, Hahn A, Kubicka S, Schneider A, Wedemeyer J, Klempnauer J . Diagnostic value of ultrasound in detection of biliary tract complications after liver transplantation. Hepat Mon. 2013; 13(1):e6003. PMC: 3589881. DOI: 10.5812/hepatmon.6003. View

Moench C, Moench K, Lohse A, Thies J, Otto G . Prevention of ischemic-type biliary lesions by arterial back-table pressure perfusion. Liver Transpl. 2003; 9(3):285-9. DOI: 10.1053/jlts.2003.50015. View

Buis C, Hoekstra H, Verdonk R, Porte R . Causes and consequences of ischemic-type biliary lesions after liver transplantation. J Hepatobiliary Pancreat Surg. 2006; 13(6):517-24. DOI: 10.1007/s00534-005-1080-2. View

McDiarmid S, Merion R, Dykstra D, Harper A . Selection of pediatric candidates under the PELD system. Liver Transpl. 2004; 10(10 Suppl 2):S23-30. DOI: 10.1002/lt.20272. View

Shastri Y, Hoepffner N, Akoglu B, Zapletal C, Bechstein W, Caspary W . Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation. World J Gastroenterol. 2007; 13(20):2819-25. PMC: 4395633. DOI: 10.3748/wjg.v13.i20.2819. View

Nakamura N, Nishida S, Neff G, Vaidya A, Levi D, Kato T . Intrahepatic biliary strictures without hepatic artery thrombosis after liver transplantation: an analysis of 1,113 liver transplantations at a single center. Transplantation. 2005; 79(4):427-32. DOI: 10.1097/01.tp.0000152800.19986.9e. View

Oh S, Kim K, Kim D, Lee Y, Rhee K, Jang J . Long-term outcomes of pediatric living donor liver transplantation at a single institution. Pediatr Transplant. 2010; 14(7):870-8. DOI: 10.1111/j.1399-3046.2010.01357.x. View

Ghinolfi D, De Simone P, Lai Q, Pezzati D, Coletti L, Balzano E . Risk analysis of ischemic-type biliary lesions after liver transplant using octogenarian donors. Liver Transpl. 2016; 22(5):588-98. DOI: 10.1002/lt.24401. View

10.

CAMPBELL W, Sheng R, Zajko A, Abu-Elmagd K, Demetris A . Intrahepatic biliary strictures after liver transplantation. Radiology. 1994; 191(3):735-40. DOI: 10.1148/radiology.191.3.8184054. View

11.

Pirenne J, Van Gelder F, Coosemans W, Aerts R, Gunson B, Koshiba T . Type of donor aortic preservation solution and not cold ischemia time is a major determinant of biliary strictures after liver transplantation. Liver Transpl. 2001; 7(6):540-5. DOI: 10.1053/jlts.2001.24641. View

12.

Goldschmidt I, Stieghorst H, Munteanu M, Poynard T, Schlue J, Streckenbach C . The use of transient elastography and non-invasive serum markers of fibrosis in pediatric liver transplant recipients. Pediatr Transplant. 2013; 17(6):525-34. DOI: 10.1111/petr.12116. View

13.

Bonini G, Pezzotta G, Morzenti C, Agazzi R, Nani R . Contrast-enhanced ultrasound with SonoVue in the evaluation of postoperative complications in pediatric liver transplant recipients. J Ultrasound. 2013; 10(2):99-106. PMC: 3478709. DOI: 10.1016/j.jus.2007.02.008. View

14.

Wang H, Jiang W, Zhou Z, Long J, Li W, Fan S . Liver transplantation in mainland China: the overview of CLTR 2011 annual scientific report. Hepatobiliary Surg Nutr. 2014; 2(4):188-97. PMC: 3924683. DOI: 10.3978/j.issn.2304-3881.2013.08.09. View

15.

Fisher A, Miller C . Ischemic-type biliary strictures in liver allografts: the Achilles heel revisited?. Hepatology. 1995; 21(2):589-91. View

16.

Langrehr J, Schneller A, Neuhaus R, Vogl T, Hintze R, Neuhaus P . [Etiologic factors and incidence of ischemic type biliary lesions (ITBL) after liver transplantation]. Langenbecks Arch Chir Suppl Kongressbd. 1999; 115:1560-2. View

17.

Kasahara M, Sakamoto S, Fukuda A . Pediatric living-donor liver transplantation. Semin Pediatr Surg. 2017; 26(4):224-232. DOI: 10.1053/j.sempedsurg.2017.07.008. View

18.

Sanchez-Urdazpal L, Gores G, Ward E, Maus T, Buckel E, Steers J . Diagnostic features and clinical outcome of ischemic-type biliary complications after liver transplantation. Hepatology. 1993; 17(4):605-9. DOI: 10.1002/hep.1840170413. View

19.

Barshes N, Lee T, Udell I, OMahoney C, Karpen S, Carter B . The pediatric end-stage liver disease (PELD) model as a predictor of survival benefit and posttransplant survival in pediatric liver transplant recipients. Liver Transpl. 2006; 12(3):475-80. DOI: 10.1002/lt.20703. View

20.

Lee S, Joo D, Kim S, Kim M, Lee A, Choi G . Graft function measured by transient elastography in living donor liver transplantation: preliminary. Transplant Proc. 2013; 45(8):3028-31. DOI: 10.1016/j.transproceed.2013.08.051. View