Background： BiNary cast syndrome （BCS） was a postoperative complication of orthotopic liver transplantation （OLT）, and the reason for BSC was considered to relate with ischemic type biliary lesions. This study ai...Background： BiNary cast syndrome （BCS） was a postoperative complication of orthotopic liver transplantation （OLT）, and the reason for BSC was considered to relate with ischemic type biliary lesions. This study aimed to evaluate the relationship between BCS following OLT and the hepatic artery resistance index （HARt）, and to observe pathological changes and morphology of biliary casts. Methods： Totally, 18 patients were diagnosed with BCS by cholangiography following OLT using choledochoscope or endoscopic retrograde cholangiopancreatography. In addition, 36 patients who did not present with BCS in the corresponding period had detectable postoperative HARI on weeks I, 2, 3 shown by color Doppler flow imaging. The compositions ofbiliary casts were analyzed by pathological examination and scanning electron microscopy. Results： HARI values of the BCS group were significantly decreased as compared with the non-BCS group on postoperative weeks 2 and 3 （P 〈 0.05）. Odds ratio （OR） analysis of HARI 1, HARI 2, HARI 3 following the operation was 〉1 （OR = 1.300： 1.223 and 1.889, respectively）. The OR of HARI 3 was statistically significant （OR - 1.889; 95% confidence interval - 1.166-7.490; P - 0.024）. The compositions of biliary casts were different when bile duct stones wcrc present. Furthermore, vascular epithelial cells were found by pathological examination in binary casts. Conclusions： HARI may possibly serve as an independent risk factor and early predictive factor of BCS. Components and formation of binary casts and bile duct stones are different.展开更多
基金Source of Support： This study was supported by grants from Science and Technology, Development Plan of Shandong Province （No. 2011GSF 11836）, Natural Science Foundation of Shandong Province （No. ZR2012HM029）, Science and Technology Development Plan of Jinan City （No. 20140821 ）. Conflict of Interest： None declared.ACKNOWLEDGMENTS We thank Prof. Cong Cheng for all statistical analyses, who is director of the teaching and research section of statistics of Taishan Medical University.
文摘Background： BiNary cast syndrome （BCS） was a postoperative complication of orthotopic liver transplantation （OLT）, and the reason for BSC was considered to relate with ischemic type biliary lesions. This study aimed to evaluate the relationship between BCS following OLT and the hepatic artery resistance index （HARt）, and to observe pathological changes and morphology of biliary casts. Methods： Totally, 18 patients were diagnosed with BCS by cholangiography following OLT using choledochoscope or endoscopic retrograde cholangiopancreatography. In addition, 36 patients who did not present with BCS in the corresponding period had detectable postoperative HARI on weeks I, 2, 3 shown by color Doppler flow imaging. The compositions ofbiliary casts were analyzed by pathological examination and scanning electron microscopy. Results： HARI values of the BCS group were significantly decreased as compared with the non-BCS group on postoperative weeks 2 and 3 （P 〈 0.05）. Odds ratio （OR） analysis of HARI 1, HARI 2, HARI 3 following the operation was 〉1 （OR = 1.300： 1.223 and 1.889, respectively）. The OR of HARI 3 was statistically significant （OR - 1.889; 95% confidence interval - 1.166-7.490; P - 0.024）. The compositions of biliary casts were different when bile duct stones wcrc present. Furthermore, vascular epithelial cells were found by pathological examination in binary casts. Conclusions： HARI may possibly serve as an independent risk factor and early predictive factor of BCS. Components and formation of binary casts and bile duct stones are different.
