Preliminary study of early diagnosis by contrast-enhanced ultrasound combined with mesenchymal stem cell therapy in improving prognosis of biliary ischemia after liver transplantation
10.3969/j.issn.1674-7445.2021.03.011
- VernacularTitle:超声造影早期检出联合间充质干细胞治疗改善肝移植术后胆道缺血预后的初步探讨
- Author:
Yuejun LIN
1
;
Bowen ZHENG
;
Tao WU
;
Huichao ZHOU
;
Mei LIAO
;
Yan LYU
;
Yuting HE
;
Jie REN
Author Information
1. Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
- Publication Type:Research Article
- Keywords:
Contrast-enhanced ultrasound (CEUS);
Mesenchymal stem cell (MSC);
Liver transplantation;
Non-anastomotic biliary stricture (NAS);
Biliary ischemia;
Endoscopic retrograde cholangiopancreatography (ERCP);
Magnetic resonance cholangiopancreatography (MRCP);
Percutaneous transhepatic cholangial drainage (PTCD)
- From:
Organ Transplantation
2021;12(3):324-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of early diagnosis by contrast-enhanced ultrasound (CEUS) combined with mesenchymal stem cell (MSC) therapy in the treatment of biliary ischemia after liver transplantation. Methods Clinical data of 9 recipients presenting with biliary ischemia detected by CEUS within 4 weeks after liver transplantation and diagnosed with non-anastomotic biliary stricture (NAS) within postoperative 1 year were retrospectively analyzed. In the conventional treatment group, 4 recipients were treated with conventional treatment including liver protection, cholagogic therapy and interventional therapy. In MSC treatment group, 5 recipients received intravenous infusion of MSC at 1, 2, 4, 8, 12 and 16 weeks after biliary ischemia detected by CEUS on the basis of conventional therapy. The interventional treatment and clinical prognosis within 1 year after liver transplantation were analyzed between two groups. Results Two recipients in the MSC treatment group required interventional therapy, which was initially given at 7-9 months after liver transplantation for 1-2 times. All recipients in the conventional treatment group required interventional therapy, which was initially delivered at postoperative 1-3 months for 2-6 times, earlier than that in the MSC treatment group. Within 1 year following liver transplantation, diffuse bile duct injury occurred in 2 recipients in MSC treatment group, and no graft dysfunction was observed. In the conventional treatment group, all recipients developed diffuse bile duct injury, and 2 recipients presented with graft dysfunction. Conclusions Early diagnosis of biliary ischemia after liver transplantation by CEUS combined with MSC therapy may delay and reduce the requirement of interventional therapy for NAS, and also improve clinical prognosis of the recipients.
