Altered bile composition after liver transplantation is associated with the development of nonanastomotic biliary strictures

Autor: Folkert Kuipers, DS Visser, Carlijn I. Buis, Elizabeth B. Haagsma, Henkjan J. Verkade, Robert J. Porte, E Geuken
Přispěvatelé: Center for Liver, Digestive and Metabolic Diseases (CLDM), Groningen Institute for Organ Transplantation (GIOT), Lifestyle Medicine (LM)
Jazyk: angličtina
Rok vydání: 2009
Předmět:
Male
medicine.medical_treatment
CHOLANGIOCYTE PROLIFERATION
Cholangiocyte proliferation
Constriction
Pathologic
SALTS
Liver transplantation
Bile salts
Gastroenterology
COLD ISCHEMIA TIME
Cohort Studies
chemistry.chemical_compound
Postoperative Complications
DUCT COMPLICATIONS
Bile
Prospective Studies
Gamma-glutamyltransferase
Biliary Tract
Phospholipids
Bile duct injury
Cholestasis
biology
Alanine Transaminase
gamma-Glutamyltransferase
Middle Aged
Ursodeoxycholic acid
Cholesterol
Biliary tract
SECRETION
Female
medicine.drug
Adult
medicine.medical_specialty
digestive system
Bile Acids and Salts
Internal medicine
ORGANIC-ANIONS
medicine
INJURY
Humans
Aspartate Aminotransferases
Nonanastomotic strictures
PRESERVATION
ACID TRANSPORTER
Hepatology
business.industry
Bile Salt Export Pump
Transplantation
chemistry
biology.protein
RISK-FACTORS
business
Zdroj: Journal of Hepatology, 50(1), 69-79. ELSEVIER SCIENCE BV
ISSN: 0168-8278
Popis: Background/Aims: Nonanastomotic biliary strictures are troublesome complications after liver transplantation. The pathogenesis of NAS is not completely clear, but experimental studies suggest that bile salt toxicity is involved.Methods: In one hundred and eleven adult liver transplants, bile samples were collected daily posttransplantation for determination of bile composition. Expression of bile transporters was studied perioperatively.Results: Nonanastomotic biliary strictures were detected in 14 patients (13%) within one year after transplantation. Patient and donor characteristics and postoperative serum liver enzymes were similar between patients who developed nonanastomotic biliary strictures and those who (lid not. Secretions of bile salts, phospholipids and cholesterol were significantly lower in patients who developed strictures. In parallel, biliary phospholipids/bile salt ratio was lower in patients developing strictures, suggestive for increased bile cytotoxicity. There were no differences in bile salt pool composition or in hepatobiliary transporter expression.Conclusions: Although patients who develop nonanastomotic biliary strictures are initially clinically indiscernible from patients who do not develop nonanastomotic biliary strictures, the biliary bile salts and phospholipids secretion, as well as biliary phospholipids/bile salt ratio in the first week after transplantation, was significantly lower if] the former group. This supports the concept that bile cytotoxicity is involved in the pathogenesis of nonanastomotic biliary strictures. (C) 2008 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Databáze: OpenAIRE
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