Re: post tx biliary strictures - question

[Guest guest]

Dear Deb;

I hope you don't mind me asking, but do your doctors think that this

may be ischemic cholangitis (?):

________________

Mayo Clin Proc. 1998 Apr;73(4):380-5.

Ischemic cholangitis.

Batts KP.

Division of Anatomic Pathology, Mayo Clinic Rochester, Minnesota

55905, USA.

Ischemia-induced bile duct lesions have been collectively labeled as

ischemic cholangitis. The biliary epithelium is dependent on arterial

blood flow, unlike the hepatic parenchyma with its dual arterial and

portal venous blood supply. As such, the biliary epithelium is

susceptible to injury when arterial blood flow is compromised. This

compromise can occur at the level of the major, named hepatic artery

branches or at the microscopic, peribiliary capillary plexus level.

Typically, ischemic cholangitis manifests as segmental strictures and

cholangiectases with resultant mechanical impairment of bile flow

and, occasionally, secondary infection of the biliary system.

Ischemic cholangitis after liver transplantation is becoming an

important problem and likely is attributable to numerous factors.

Hepatic arterial infusion of chemotherapy and systemic vasculitis are

other causes of ischemic cholangitis. The role of ischemia in other

chronic biliary and ductopenic diseases remains speculative.

Publication Types:

Review

Review, Tutorial

PMID: 9559044

________________

Best regards,

Dave

(father of (20); PSC 07/03; UC 08/03)

>Thoughts anyone?

[Guest guest]

,

That term has never been mentioned. The day before the tx, my

surgeon said that I would be at higher risk for biliary strictures

post-tx since we were doing living donor -that this occurs in 25% of

those cases and that it would be a complication that would appear

down the road (not the first week or two). Additionally, in the

literature you've collected on PSC-lit, the abstracts suggest that

having PSC prior to tx also is a risk factor for bile strictures

post-tx.

Mike's ducts were so small that the surgeon had to use pediatric

stents when he sewed them to my intestine. Initially, they were

thinking that the stent may have just been clogged, but after my MRI

that hasn't been mentioned. What they've suggested to this point is

that the duct has simply healed together instead of open. If it were

an ischemic issue, I'd think there would have to be other signs of

impaired blood flow. I don't have any signs of that with *perfect*

biopsies and ultrasounds. (I've had at least two ultrasounds to

measure the blood flow in the liver since tx.)

Thanks for the thought, though. Looks like tomorrow will be the

earliest that I'll hear something.

Deb in VA

PSC 1998, UC 1999, Listed Ltx 2001, LDLTX 5/19/2005, post-tx

cholangitis dx 7/20/2005

> Dear Deb;

>

> I hope you don't mind me asking, but do your doctors think that

this

> may be ischemic cholangitis (?):

>

[Guest guest]

Deb,

Good luck trying to get at the bottom of your problems post-tx. I'm thinking of you!

Ricky

Re: post tx biliary strictures - question

,That term has never been mentioned. The day before the tx, my surgeon said that I would be at higher risk for biliary strictures post-tx since we were doing living donor -that this occurs in 25% of those cases and that it would be a complication that would appear down the road (not the first week or two). Additionally, in the literature you've collected on PSC-lit, the abstracts suggest that having PSC prior to tx also is a risk factor for bile strictures post-tx. Thanks for the thought, though. Looks like tomorrow will be the earliest that I'll hear something.Deb in VAPSC 1998, UC 1999, Listed Ltx 2001, LDLTX 5/19/2005, post-tx cholangitis dx 7/20/2005> Dear Deb;> > I hope you don't mind me asking, but do your doctors think that this > may be ischemic cholangitis (?):>

[Guest guest]

Dear Deb;

Sorry for introducing a false lead ... I just thought that ischemic

cholangitis might be a possibility? It sounds like this may have

already been ruled out. I do hope you get an answer tomorrow!

Best regards,

Dave R.