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  • 1 Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
  • 2 Department of Transplantation and Surgery, Semmelweis University, Baross u. 23, H-1082, Budapest, Hungary
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Abstract

Introduction: Biliary strictures remain a key problem after liver transplantation. Anastomotic strictures are treated by surgery or interventional therapy. Intrahepatic stenosis requires retransplantation. For bridging, percutaneous and endoscopic interventions are used. The extent of the strictures may have an important role in therapy planning. Methods: Strictures were divided into four zones (1: extrahepatic, not included in this study; 2: hilar; 3: central; 4: peripheral). Twenty patients were treated with balloon dilatation/stent implantation/retransplantation/supportive care (Zone 1: 0/0/0/0; Zone 2: 8/7/2/0; Zone 3: 7/5/2/1; Zone 4: 1/1/3/1). Results: Mean follow-up time was 48 months. In Zone 2, one patient died as a result of recurrent hepatocellular carcinoma (HCC), and seven patients are alive, five after stent placements and two after retransplantation. Four patients are alive in Zone 3: all had stent placements and one later retransplantation. One patient died after retransplantation, two on the waiting list, and one due to chronic liver failure. One patient is alive in Zone 4 after early retransplantation, and three died. Conclusion: Percutaneous therapy is safe and effective in intrahepatic biliary stenosis after liver transplantation. It can provide the cure or bridge retransplantation. Based on zonal classification, we recommend the following treatments: Zone 4: early retransplantation; Zone 2: minimally invasive therapy; Zone 3: individual decisions.

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  • Medicine (miscellaneous) SJR Quartile Score (2018): Q3
  • Scimago Journal Rank (2018): 0.228
  • SJR Hirsch-Index (2018): 11

Language: English

Founded in 2008
Publication: One volume of four issues annually
Publication Programme: 2020. Vol. 12.

Publishing Model: Open Access with no author fee

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Senior editors

Editor(s)-in-Chief: Ágoston Szél

Vice Editor(s)-in-Chief: János Gál

Vice Editor(s)-in-Chief: Kálmán Hüttl

Vice Editor(s)-in-Chief: Béla Merkely

Chair of the Editorial Board: Balázs Hauser

Editorial Board

  • Miklós Antal (University of Debrecen, Hungary)
  • Enrico Calzia (Universitätsklinikum Ulm, Germany)
  • Zoltán Csanádi (University of Debrecen, Hungary)
  • Attila Doros (Semmelweis University, Hungary)
  • Edit Dósa (Semmelweis University, Hungary)
  • Dariusz Dudek (Jagiellonian University, Poland)
  • Susumu Eguchi (Nagasaki University, Japan)
  • László Entz (Semmelweis University, Hungary)
  • Nagy A. Habib (Imperial College London, UK)
  • Balázs Hauser (Semmelweis University, Hungary)
  • Miklós D. Kertai (Duke University, USA)
  • András Komócsi (University of Pécs, Hungary)
  • Karl-Heinz Kuck (Asklepios Klinik St. Georg, Germany)
  • Pal Maurovich-Horvat (Semmelweis University, Hungary)
  • Péter Metzger (Danube Hospital/SMZ-Ost, Austria)
  • László Miskolczi (University of Miami, USA)
  • Balázs Nemes (University of Debrecen, Hungary)
  • Attila Oláh (Petz Aladár County and Teaching Hospital, Hungary)
  • Wojciech G. Polak (Erasmus Medical Center, The Netherlands)
  • Robert Reisch (Clinic Hirslanden Zurich, Switzerland)
  • Bernhard Riedel (Vanderbilt University Medical Center, USA)
  • David Royston (Harefield Hospital, UK)
  • Thomas A. Sos (New York Presbyterian Hospital, USA)
  • Wolfgang Trubel (Privatklinik Doebling, Austria)

Semmelweis University. Institute of Human Morphology and Developmental Biology
Address: Tűzoltó u. 58. H-1094 Budapest, Hungary
E-mail: szel@ana2.sote.hu

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