ISCHEMIC TYPE BILIARY LESIONS FOLLOWING L IVER-TRANSPLANTATION - A 2-YEAR EXPERIENCE

Ischemic type lesions (ITL) after orthotopic liver transplantation are characterized by bile duct necroses leading to alterations of the duc tal lumen, biliary leakage, cast formation and, thereby, to cholestasi s. After exclusion of causative factors, such as arterial thrombosis, ABO incompatibility and chronic rejection, ITL occurred in 21 of 165 p atients. The rate of ITL after UW preservation was higher (25%) in gra fts preserved for >10 hours in comparison to <10 hours (7%; p <0,05). Treatment consisted of endoscopic and percutaneous intervention, surgi cal revision and retransplantation. Retransplantation is indicated in many patients with lesions of extra- and intrahepatic bile ducts (type A). Other methods are of palliative character and may only be success ful in type B (extrahepatic) lesions. Morbidity in patients with ITL i s considerable. In comparison to patients without ITL, mortality, howe ver, is not increased.