Ultrasound-Based Multimodal Imaging Predicting Ischemic-Type Biliary Lesions After Living-Donor Liver Transplantation

International Journal of General Medicine

关键词: ischemic-type biliary lesions;    living-donor liver transplantation;    pediatric patients;    biliary atresia;    color doppler flow imaging;    liver stiffness measurement;   

DOI  :  

来源: DOAJ

【 摘 要 】

Jin-qiao Liu, Wen-juan Chen, Meng-jie Zhou, Wen-feng Li, Ju Tang Department of Ultrasound, Hunan Children’s Hospital, Changsha City, Hunan Province, People’s Republic of ChinaCorrespondence: Wen-juan ChenDepartment of Ultrasound, Hunan Children’s Hospital, No. 86 Ziyuan Road, Changsha City, Hunan Province, 410007, People’s Republic of ChinaTel + 86-13707484196Email [e-mail]: Ischemic-type biliary lesions (ITBL) are accepted as the most incomprehensible biliary complications after living-donor liver transplantation (LDLT). Early predicting the development of ITBL in pediatric patients permits more preventive strategies. However, few studies have focused on the early prediction of ITBL.Objective: This study aimed to establish a nomogram including ultrasound-based multimodal imaging to predict ITBL in children with biliary atresia (BA) within 2 years after receiving LDLT.Methods: The records of 94 BA children with at least one year of follow-up after LDLT were reviewed retrospectively. They were randomly divided into a training cohort for constructing a nomogram (n=64) and a validation cohort (n=30). In the training cohort, patients diagnosed as ITBL were included in the ITBL group and those without any vascular and biliary complication were included in the non-ITBL group. Multivariate Cox regression was used for the establishment of the nomogram in predicting the risk of ITBL within 2 years post-LDLT. The discrimination and calibration of the nomogram were internally and externally validated. The performances of the nomogram and the individual components were compared by the area under the curve (AUC) of receiver operating characteristic (ROC) curve.Results: In the training cohort, 18 BA children were included in the ITBL group and 46 were in the non-ITBL group. Last pediatric end-stage liver disease (PELD) score, gamma-glutamyl transpeptidase (GGT), resistive index (RI), and liver stiffness measurement (LSM) were the independent predictors for the development of ITBL within 2 years post-LDLT. The nomogram incorporating these independent predictors showed good discrimination and calibration by the internal and external validation. Its performance was better than any individual component in predicting the prognosis (P < 0.05).Conclusion: The established nomogram may be used to predict the risk of ITBL within 2 years post-LDLT in BA children.Keywords: ischemic-type biliary lesions, living-donor liver transplantation, pediatric patients, biliary atresia, color Doppler flow imaging, liver stiffness measurement

【 授权许可】

Unknown