Low Measured Hepatic Artery Flow Increases Rate of Biliary Strictures in Deceased Donor Liver Transplantation: An Age-Dependent Phenomenon
BACKGROUNDThis study was conducted to determine effect of lower measured hepatic arterial (HA) flow (
Gespeichert in:
| Veröffentlicht in: | Transplantation 2017-02, Vol.101 (2), p.332-340 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 340 |
|---|---|
| container_issue | 2 |
| container_start_page | 332 |
| container_title | Transplantation |
| container_volume | 101 |
| creator | Kim, Peter T W Fernandez, Hoylan Gupta, Amar Saracino, Giovanna Ramsay, Michael McKenna, Gregory J Testa, Giuliano Anthony, Tiffany Onaca, Nicholas Ruiz, Richard M Klintmalm, Goran B |
| description | BACKGROUNDThis study was conducted to determine effect of lower measured hepatic arterial (HA) flow ( |
| doi_str_mv | 10.1097/TP.0000000000001564 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1852662049</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1852662049</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3034-2d2fe272174e44912ae62944b17d68dd702c6ddd5ec38d284cc17bfb9064fe733</originalsourceid><addsrcrecordid>eNp9kc1OGzEUha2KClLgCSohL9lM8N-MZ7pLk4YgpSKi6Xrk2HfIwMQebE-jvkKfGqMAqrqoJcuL851zfe9F6DMlY0oqebVejclfh-aF-IBGNOciK0hJjtCIEEEzyrk8QZ9CeEhQzqU8RidMVoIKXo7Qn6Xb4--gwuDB4AX0KrYaT3wE_xvPuyTeWO2TDgHfqQjYNfhr27UqyT-ib3VMxoBbi2egXzCDZ846j5ftL_B47ZUNfadsTLnOfsETiyf3kM2gB2vARrzagnW7dO0Z-tioLsD563uKfs6_raeLbHl7fTOdLDPNSeqNGdYAk4xKAUJUlCkoWCXEhkpTlMZIwnRhjMlB89KwUmhN5abZVKQQDUjOT9HlIbf37mmAEOtdGzR06ZfghlDTMmdFwYioEsoPqPYuBA9N3ft2l3qvKalfllCvV_W_S0iui9cCw2YH5t3zNvUEyAOwd10adHjshj34eguqi9v_Rj8D5ZyTuQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1852662049</pqid></control><display><type>article</type><title>Low Measured Hepatic Artery Flow Increases Rate of Biliary Strictures in Deceased Donor Liver Transplantation: An Age-Dependent Phenomenon</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Kim, Peter T W ; Fernandez, Hoylan ; Gupta, Amar ; Saracino, Giovanna ; Ramsay, Michael ; McKenna, Gregory J ; Testa, Giuliano ; Anthony, Tiffany ; Onaca, Nicholas ; Ruiz, Richard M ; Klintmalm, Goran B</creator><creatorcontrib>Kim, Peter T W ; Fernandez, Hoylan ; Gupta, Amar ; Saracino, Giovanna ; Ramsay, Michael ; McKenna, Gregory J ; Testa, Giuliano ; Anthony, Tiffany ; Onaca, Nicholas ; Ruiz, Richard M ; Klintmalm, Goran B</creatorcontrib><description>BACKGROUNDThis study was conducted to determine effect of lower measured hepatic arterial (HA) flow (<400 mL/min) on biliary complications and graft survival after deceased donor liver transplantation. Hepatic artery is the main blood supply to bile duct and lack of adequate HA flow is thought to be a risk factor for biliary complications.
METHODSA retrospective review of 1300 patients who underwent deceased donor liver transplantation was performed. Patients with arterial complications were excluded to eliminate potential contribution to biliary complications from HA thrombosis. Patients were divided into low (<400 mL/min; N = 201) and high (≥400 mL/min; N = 1099) HA flow groups. Incidence of biliary complications and graft survival were analyzed.
RESULTSHA flows less than 400 mL/min were associated with increased rate of biliary strictures in younger donors (<50 years old), and in patients with duct-to-duct anastomoses (P = 0.028). Lower HA flows were associated with decreased graft survival (P = 0.013). Donor older than 50 years was associated with increased rate of biliary strictures (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.14-2.45; P = 0.0085) and graft failure (HR, 1.68; 95% CI, 1.35-2.1; P <0.0001) on multivariate analyses. HA flow less than 400 mL/min was associated with biliary strictures (HR, 1.53; 95% CI, 1.04-2.24; P = 0.0297) on univariate analysis only.
CONCLUSIONSHA flow less than 400 mL/min was associated with higher rate of biliary strictures in younger donors with duct-to-duct reconstruction and lower graft survival. A consideration should be given to increase the intraoperative HA flow to prevent biliary strictures in such patients.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/TP.0000000000001564</identifier><identifier>PMID: 27941438</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Age Factors ; Anastomosis, Surgical ; Biliary Tract Surgical Procedures - adverse effects ; Blood Flow Velocity ; Cause of Death ; Chi-Square Distribution ; Cholestasis - diagnosis ; Cholestasis - etiology ; Female ; Graft Survival ; Hepatic Artery - physiopathology ; Hepatic Artery - surgery ; Humans ; Kaplan-Meier Estimate ; Liver Transplantation - adverse effects ; Male ; Middle Aged ; Multivariate Analysis ; Regional Blood Flow ; Retrospective Studies ; Risk Factors ; Time Factors ; Tissue Donors ; Treatment Outcome</subject><ispartof>Transplantation, 2017-02, Vol.101 (2), p.332-340</ispartof><rights>Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3034-2d2fe272174e44912ae62944b17d68dd702c6ddd5ec38d284cc17bfb9064fe733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27941438$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Peter T W</creatorcontrib><creatorcontrib>Fernandez, Hoylan</creatorcontrib><creatorcontrib>Gupta, Amar</creatorcontrib><creatorcontrib>Saracino, Giovanna</creatorcontrib><creatorcontrib>Ramsay, Michael</creatorcontrib><creatorcontrib>McKenna, Gregory J</creatorcontrib><creatorcontrib>Testa, Giuliano</creatorcontrib><creatorcontrib>Anthony, Tiffany</creatorcontrib><creatorcontrib>Onaca, Nicholas</creatorcontrib><creatorcontrib>Ruiz, Richard M</creatorcontrib><creatorcontrib>Klintmalm, Goran B</creatorcontrib><title>Low Measured Hepatic Artery Flow Increases Rate of Biliary Strictures in Deceased Donor Liver Transplantation: An Age-Dependent Phenomenon</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>BACKGROUNDThis study was conducted to determine effect of lower measured hepatic arterial (HA) flow (<400 mL/min) on biliary complications and graft survival after deceased donor liver transplantation. Hepatic artery is the main blood supply to bile duct and lack of adequate HA flow is thought to be a risk factor for biliary complications.
METHODSA retrospective review of 1300 patients who underwent deceased donor liver transplantation was performed. Patients with arterial complications were excluded to eliminate potential contribution to biliary complications from HA thrombosis. Patients were divided into low (<400 mL/min; N = 201) and high (≥400 mL/min; N = 1099) HA flow groups. Incidence of biliary complications and graft survival were analyzed.
RESULTSHA flows less than 400 mL/min were associated with increased rate of biliary strictures in younger donors (<50 years old), and in patients with duct-to-duct anastomoses (P = 0.028). Lower HA flows were associated with decreased graft survival (P = 0.013). Donor older than 50 years was associated with increased rate of biliary strictures (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.14-2.45; P = 0.0085) and graft failure (HR, 1.68; 95% CI, 1.35-2.1; P <0.0001) on multivariate analyses. HA flow less than 400 mL/min was associated with biliary strictures (HR, 1.53; 95% CI, 1.04-2.24; P = 0.0297) on univariate analysis only.
CONCLUSIONSHA flow less than 400 mL/min was associated with higher rate of biliary strictures in younger donors with duct-to-duct reconstruction and lower graft survival. A consideration should be given to increase the intraoperative HA flow to prevent biliary strictures in such patients.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Anastomosis, Surgical</subject><subject>Biliary Tract Surgical Procedures - adverse effects</subject><subject>Blood Flow Velocity</subject><subject>Cause of Death</subject><subject>Chi-Square Distribution</subject><subject>Cholestasis - diagnosis</subject><subject>Cholestasis - etiology</subject><subject>Female</subject><subject>Graft Survival</subject><subject>Hepatic Artery - physiopathology</subject><subject>Hepatic Artery - surgery</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Liver Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Regional Blood Flow</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Tissue Donors</subject><subject>Treatment Outcome</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1OGzEUha2KClLgCSohL9lM8N-MZ7pLk4YgpSKi6Xrk2HfIwMQebE-jvkKfGqMAqrqoJcuL851zfe9F6DMlY0oqebVejclfh-aF-IBGNOciK0hJjtCIEEEzyrk8QZ9CeEhQzqU8RidMVoIKXo7Qn6Xb4--gwuDB4AX0KrYaT3wE_xvPuyTeWO2TDgHfqQjYNfhr27UqyT-ib3VMxoBbi2egXzCDZ846j5ftL_B47ZUNfadsTLnOfsETiyf3kM2gB2vARrzagnW7dO0Z-tioLsD563uKfs6_raeLbHl7fTOdLDPNSeqNGdYAk4xKAUJUlCkoWCXEhkpTlMZIwnRhjMlB89KwUmhN5abZVKQQDUjOT9HlIbf37mmAEOtdGzR06ZfghlDTMmdFwYioEsoPqPYuBA9N3ft2l3qvKalfllCvV_W_S0iui9cCw2YH5t3zNvUEyAOwd10adHjshj34eguqi9v_Rj8D5ZyTuQ</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Kim, Peter T W</creator><creator>Fernandez, Hoylan</creator><creator>Gupta, Amar</creator><creator>Saracino, Giovanna</creator><creator>Ramsay, Michael</creator><creator>McKenna, Gregory J</creator><creator>Testa, Giuliano</creator><creator>Anthony, Tiffany</creator><creator>Onaca, Nicholas</creator><creator>Ruiz, Richard M</creator><creator>Klintmalm, Goran B</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>Low Measured Hepatic Artery Flow Increases Rate of Biliary Strictures in Deceased Donor Liver Transplantation: An Age-Dependent Phenomenon</title><author>Kim, Peter T W ; Fernandez, Hoylan ; Gupta, Amar ; Saracino, Giovanna ; Ramsay, Michael ; McKenna, Gregory J ; Testa, Giuliano ; Anthony, Tiffany ; Onaca, Nicholas ; Ruiz, Richard M ; Klintmalm, Goran B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3034-2d2fe272174e44912ae62944b17d68dd702c6ddd5ec38d284cc17bfb9064fe733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Anastomosis, Surgical</topic><topic>Biliary Tract Surgical Procedures - adverse effects</topic><topic>Blood Flow Velocity</topic><topic>Cause of Death</topic><topic>Chi-Square Distribution</topic><topic>Cholestasis - diagnosis</topic><topic>Cholestasis - etiology</topic><topic>Female</topic><topic>Graft Survival</topic><topic>Hepatic Artery - physiopathology</topic><topic>Hepatic Artery - surgery</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Liver Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Regional Blood Flow</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Tissue Donors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Peter T W</creatorcontrib><creatorcontrib>Fernandez, Hoylan</creatorcontrib><creatorcontrib>Gupta, Amar</creatorcontrib><creatorcontrib>Saracino, Giovanna</creatorcontrib><creatorcontrib>Ramsay, Michael</creatorcontrib><creatorcontrib>McKenna, Gregory J</creatorcontrib><creatorcontrib>Testa, Giuliano</creatorcontrib><creatorcontrib>Anthony, Tiffany</creatorcontrib><creatorcontrib>Onaca, Nicholas</creatorcontrib><creatorcontrib>Ruiz, Richard M</creatorcontrib><creatorcontrib>Klintmalm, Goran B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Peter T W</au><au>Fernandez, Hoylan</au><au>Gupta, Amar</au><au>Saracino, Giovanna</au><au>Ramsay, Michael</au><au>McKenna, Gregory J</au><au>Testa, Giuliano</au><au>Anthony, Tiffany</au><au>Onaca, Nicholas</au><au>Ruiz, Richard M</au><au>Klintmalm, Goran B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low Measured Hepatic Artery Flow Increases Rate of Biliary Strictures in Deceased Donor Liver Transplantation: An Age-Dependent Phenomenon</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2017-02</date><risdate>2017</risdate><volume>101</volume><issue>2</issue><spage>332</spage><epage>340</epage><pages>332-340</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><abstract>BACKGROUNDThis study was conducted to determine effect of lower measured hepatic arterial (HA) flow (<400 mL/min) on biliary complications and graft survival after deceased donor liver transplantation. Hepatic artery is the main blood supply to bile duct and lack of adequate HA flow is thought to be a risk factor for biliary complications.
METHODSA retrospective review of 1300 patients who underwent deceased donor liver transplantation was performed. Patients with arterial complications were excluded to eliminate potential contribution to biliary complications from HA thrombosis. Patients were divided into low (<400 mL/min; N = 201) and high (≥400 mL/min; N = 1099) HA flow groups. Incidence of biliary complications and graft survival were analyzed.
RESULTSHA flows less than 400 mL/min were associated with increased rate of biliary strictures in younger donors (<50 years old), and in patients with duct-to-duct anastomoses (P = 0.028). Lower HA flows were associated with decreased graft survival (P = 0.013). Donor older than 50 years was associated with increased rate of biliary strictures (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.14-2.45; P = 0.0085) and graft failure (HR, 1.68; 95% CI, 1.35-2.1; P <0.0001) on multivariate analyses. HA flow less than 400 mL/min was associated with biliary strictures (HR, 1.53; 95% CI, 1.04-2.24; P = 0.0297) on univariate analysis only.
CONCLUSIONSHA flow less than 400 mL/min was associated with higher rate of biliary strictures in younger donors with duct-to-duct reconstruction and lower graft survival. A consideration should be given to increase the intraoperative HA flow to prevent biliary strictures in such patients.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27941438</pmid><doi>10.1097/TP.0000000000001564</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0041-1337 |
| ispartof | Transplantation, 2017-02, Vol.101 (2), p.332-340 |
| issn | 0041-1337 1534-6080 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1852662049 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Age Factors Anastomosis, Surgical Biliary Tract Surgical Procedures - adverse effects Blood Flow Velocity Cause of Death Chi-Square Distribution Cholestasis - diagnosis Cholestasis - etiology Female Graft Survival Hepatic Artery - physiopathology Hepatic Artery - surgery Humans Kaplan-Meier Estimate Liver Transplantation - adverse effects Male Middle Aged Multivariate Analysis Regional Blood Flow Retrospective Studies Risk Factors Time Factors Tissue Donors Treatment Outcome |
| title | Low Measured Hepatic Artery Flow Increases Rate of Biliary Strictures in Deceased Donor Liver Transplantation: An Age-Dependent Phenomenon |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T16%3A41%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Low%20Measured%20Hepatic%20Artery%20Flow%20Increases%20Rate%20of%20Biliary%20Strictures%20in%20Deceased%20Donor%20Liver%20Transplantation:%20An%20Age-Dependent%20Phenomenon&rft.jtitle=Transplantation&rft.au=Kim,%20Peter%20T%20W&rft.date=2017-02&rft.volume=101&rft.issue=2&rft.spage=332&rft.epage=340&rft.pages=332-340&rft.issn=0041-1337&rft.eissn=1534-6080&rft_id=info:doi/10.1097/TP.0000000000001564&rft_dat=%3Cproquest_cross%3E1852662049%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1852662049&rft_id=info:pmid/27941438&rfr_iscdi=true |