title: [Causes and management of ischemic-type biliary lesion after orthotopic liver transplantation].
abstract: OBJECTIVE
  To discuss the causes, diagnosis, prophylaxis and treatment of ischemic-type biliary lesions (ITBLs) following orthotopic liver transplantation (OLT).
  
  
  METHODS
  A retrospective analysis was performed for 326 OLT patients from January 2002 to January 2009. The post-OLT etiological factors and treatment of ITBL cases were analyzed.
  
  
  RESULTS
  ITBL occurred in 23 patients (7.05%). It included intrahepatic biliary lesions (n=9), extrahepatic lesions (n=12) and diffuse extrahepatic and intrahepatic biliary lesions (n=2). Through a COX regression, the risk factors were independently associated with ITBL serious hepatitis as the primary disease (RR: 3.204; P=0.014) and cold donor ischemic time beyond 11.5 hours (RR: 4.895; P=0.000). All ITBL patients underwent drug therapy, endoscopy (n=10), operation (n=6) or re-OLT (n=7). And improvement was found in 17 patients.
  
  
  CONCLUSIONS
  Avoiding too long old ischemic time of donor liver and carefully evaluating the indications of recipients are effective preventive measures of ITBL. It is crucial to select a proper treatment according to the conditions of each individual patient.
authors.affiliation: Department of Hepatobillary Surgery, General Hospital of Chinese PLA, Beijing 100853, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Jin
authors.forename: Xian-jie
authors.initials: XJ
authors.lastname: Shi
authors.forename: Mao-qiang
authors.initials: MQ
authors.lastname: Wang
authors.forename: Yu-kun
authors.initials: YK
authors.lastname: Luo
authors.forename: Feng-chun
authors.initials: FC
authors.lastname: Cai
authors.forename: Yu-rong
authors.initials: YR
authors.lastname: Liang
authors.forename: Ying
authors.initials: Y
authors.lastname: Luo
authors.forename: Wen-bin
authors.initials: WB
authors.lastname: Ji
authors.forename: Wei-dong
authors.initials: WD
authors.lastname: Duan
authors.forename: Jia-hong
authors.initials: JH
authors.lastname: Dong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000209:etiology / Q000517:prevention & control; D002648:Child; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000517:prevention & control; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D055815:Young Adult