Diagnosis of biliary strictures after liver transplantation: Which is the best tool?

Table 1 Patient characteristics.

	NoST	AST	ITBL
n	25	27	23
m/f	16/9	11/16 (P = 0.081)	13/10 (P = 0.401)
Median age (yr)	50 yr [33-63]	54 yr [33-65] (P = 0.09)	49 yr [27-63] (P = 0.94)
Type of LTx	OLTx = 17/25	OLTx = 17/27	OLTx = 20/23
	LDLTx = 5/25	(P = 0.461)	(P = 0.111)
	Split = 3/25	LDLTx = 7/27 (P = 0.431)	LDLTx = 3/23 (P = 0.401)
		Split = 3/27 (P = 0.701)	Split = 0/23 (P = 0.131)

NoST= no apparent biliary stenosis in ERC. AST= anastomotic stricture in ERC. ITBL= ischemic type biliary lesions in ERC. OLTx= orthotopic liver transplantation; LDLTx= Living donor liver transplantation.

¹Fisher’s exact test.

Table 2 Impact of indirect imaging tools on diagnosis of posttransplant biliary strictures.

	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
US-biliary congestion all	63.9	91.0	92.0	60.6
-biliary congestion AST	68.4	91.0	86.7	76.9
-biliary congestion ITBL	58.8	91.0	83.3	74.1
US-biliary stenosis	0	0	0	0
US-concomitant biliary stones all	22.0	97.0	66.7	82.5
-stones AST	0	97	0	91.7
-stones ITBL	0	97	0	94
CT-biliary congestion all	63.6	57.1	70.0	50.0
-biliary congestion AST	40.0	57.1	40.0	57.1
-biliary congestion ITBL	83.3	57.1	62.5	80.0
CT-biliary stenosis	10	0	0	43.75
CT-concomitant biliary stones	0	0	0	0
MR-biliary congestion all	83.3	25.0	83.3	25.0
-biliary congestion AST	71.4	25.0	62.5	33.3
-biliaty congestion ITBL	88.9	25.0	72.7	50.0
MR-biliary stenosis	38.9	75	87.5	21.4
MR-correct localisation of stenosis	22	75	80	17.6
MR-concomitant biliary stones all	33.0	94	50	89
-stones AST	0	94
-stones ITBL	0	94

PPV, positive predictive value; NPV, negative predictive value.

Table 3 Impact of biochemical cholestasis parameters on diagnosis of post-transplant biliary strictures¹.

	NoST	AST	ITBL
Serum bilirubin	5.7 (0.8-30)	4.1 (0.7-9.5)	2.5 (0.5-23.7)
(mg/dL)		P = 0.1792	P = 0.2452
Alkaline	360 (157-1206)	339 (72-2185)	527 (288-2256)
phosphatase (U/L)		P = 0.562	P = 0.2392
Gamma glutamyl	277 (64-832)	220 (33-1580)	239 (65-849)
	tranferase (U/L)	P = 0.062	P = 0.6692

¹Data given as median and (range);

²Mann-Whitney test.