Observational Study
Copyright ©The Author(s) 2021.
World J Hepatol. Jan 27, 2021; 13(1): 132-143
Published online Jan 27, 2021. doi: 10.4254/wjh.v13.i1.132
Table 1 Baseline characteristics reported as n (%) or mean (SD)
Variable
Overall cohort (n = 91)
Age51 (12.1)
Sex (male)68 (74.7)
Presenting symptom
Jaundice21 (23.1)
Fever11 (12.1)
Abdominal pain14 (15.4)
Asymptomatic21 (25)
Liver biopsy performed first51 (56)
Percutaneous liver biopsy65 (71.4)
Bile duct diameter (mm)4.6 (1.9)
R factor2 (2.4), Range: 0.1-6.4
Alkaline phosphatase (international units/liter)392.6 (248.4)
AST (units/liter)200.5 (674.8)
ALT (units/liter)205.4 (444.2)
Total bilirubin (mg/dL)4.5 (5.4)
Deceased donor73 (80.2)
Transplant biliary anatomy
Duct-to-duct67 (73.6)
Roux-en-Y hepaticojejunostomy24 (26.4)
Tacrolimus66 (73.3)
Sirolimus20 (22.2)
Everolimus6 (6.6)
Mycophenolate sodium28 (31.1)
Mycophenolate mofetil13 (14.4)
Cyclosporine16 (17.8)
Prednisone20 (22.2)
Immunosuppression monotherapy20 (22)
Dual immunosuppression therapy68 (74.7)
Triple immunosuppression therapy3 (3.3)
Table 2 Etiologies of liver function test elevation reported as n (%)
Single diagnosis
n (%)
Anastomotic stricture31 (34.1)
Acute cellular rejection10 (11)
Recurrent primary sclerosing cholangitis6 (19.4)
Recurrent HCV5 (5.5)
Biliary cast syndrome3 (3.3)
Ischemic cholangiopathy2 (2.2)
Papillary stenosis1 (1.1)
Posterior reversible encephalopathy syndrome 1 (1.1)
Cholestatic hepatitis 1 (1.1)
Recurrent PBC 1 (1.1)
Venous outflow obstruction1 (1.1)
Two diagnoses
Anastomotic stricture and acute cellular rejection13 (14.3)
Recurrent HCV and anastomotic stricture6 (19.4)
Bile leak and acute cellular rejection 2 (2.2)
Congestive hepatopathy and anastomotic stricture 1 (1.1)
Anastomotic stricture and suprahepatic cava stenosis1 (1.1)
Recurrent PBC and anastomotic stricture1 (1.1)
CMV hepatitis and bile leak1 (1.1)
Three diagnoses
Acute cellular rejection, anastomotic stricture, and recurrent HCV2 (2.2)
Acute cellular rejection, anastomotic stricture, and de novo autoimmune hepatitis1 (1.1)
Acute cellular rejection, anastomotic stricture, and CMV hepatitis1 (1.1)
Table 3 Operating characteristics for endoscopic retrograde cholangiopancreatography and liver biopsy in diagnosing post-liver transplant complications

ERCP
LB
ERCP + LB
Overall accuracy % (95%CI)79.1 (69.3-86.9)93.4 (86.2-97.5)100 (96-100)
Overall sensitivity % (95%CI)79.1 (69.3-86.9)93.4 (86.2-97.5)100 (96-100)
Acute cellular rejection accuracy % (95%CI)0 (0-30.9)100 (69.2-100)100 (91.9-100)
Anastomotic stricture accuracy % (95%CI)100 (84.6-100)72.7 (49.8-89.3)100 (89.4-100)