Impact of non-anastomotic biliary strictures after liver transplantation on healthcare consumption, use of ionizing radiation and infectious events

A. Boudewijn de Vries*, Jan J. Koornstra, Jerome R. Lo Ten Foe, Robert J. Porte, Aad P. van den Berg, Hans Blokzijl, Robert C. Verdonk

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)

Abstract

BackgroundNon-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.

MethodsThis 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.

ResultsForty-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).

ConclusionNAS 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.

Original languageEnglish
Pages (from-to)81-89
Number of pages9
JournalClinical Transplantation
Volume30
Issue number1
DOIs
Publication statusPublished - Jan-2016

Keywords

  • biliary complications
  • health care consumption
  • highly resistant microorganisms
  • infectious complications
  • interventional procedures
  • ionizing radiation
  • ischemic type biliary lesions
  • liver transplantation
  • RISK-FACTORS
  • COMPLICATIONS
  • BACTEREMIA
  • RECIPIENTS
  • CONSEQUENCES
  • EPIDEMIOLOGY
  • OUTCOMES
  • LESIONS

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