Endoscopy 2012; 44(12): 1158-1160
DOI: 10.1055/s-0032-1325795
Case report
© Georg Thieme Verlag KG Stuttgart · New York

Use of paclitaxel-eluting balloons for endotherapy of anastomotic strictures following liver transplantation

I. Kabar
1   Department of Transplant Medicine, University Hospital Münster, Münster, Germany
,
V. R. Cicinnati
1   Department of Transplant Medicine, University Hospital Münster, Münster, Germany
,
S. Beckebaum
1   Department of Transplant Medicine, University Hospital Münster, Münster, Germany
,
S. Cordesmeyer
1   Department of Transplant Medicine, University Hospital Münster, Münster, Germany
,
Y. Avsar
1   Department of Transplant Medicine, University Hospital Münster, Münster, Germany
,
H. Reinecke
2   Division of Angiology, Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany
,
H. H. Schmidt
1   Department of Transplant Medicine, University Hospital Münster, Münster, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
27 November 2012 (online)

Biliary anastomotic strictures after liver transplantation are a major source of morbidity and graft failure; however, repeated endoscopic therapy has shown variable long-term success rates. Thus the aim of this prospective case series was to evaluate the safety and efficacy of using paclitaxel-eluting balloons in 13 patients requiring treatment for symptomatic anastomotic strictures following liver transplantation. Sustained clinical success—defined as no need for further endoscopic intervention for at least 6 months – was achieved in 12 /13 patients (92 %). One, two, and three interventions were required in 9 (69 %), 1, and 2 patients, respectively (mean number of sessions was 1.46). Mean (± SD) bilirubin level dropped from 6.8 (± 4.1) mg/dL to 1.4 (± 0.9) mg/dL. These promising results justify carrying out a randomized comparative trial to confirm this innovative approach.

 
  • References

  • 1 Zoepf T, Maldonado-Lopez EJ, Hilgard P et al. Balloon dilatation vs. balloon dilatation plus bile duct endoprostheses for treatment of anastomotic biliary strictures after liver transplantation. Liver Transpl 2006; 12: 88-94
  • 2 Kulaksiz H, Weiss KH, Gotthardt D et al. Is stenting necessary after balloon dilation of post-transplantation biliary strictures? Results of a prospective comparative study. Endoscopy 2008; 40: 746-751
  • 3 Costamagna G, Pandolfi M, Mutignani M et al. Long-term results of endoscopic management of postoperative bile duct strictures with increasing numbers of stents. Gastrointest Endosc 2001; 54: 162-168
  • 4 Ryu CH, Lee SK. Biliary strictures after liver transplantation. Gut Liver 2011; 5: 133-142
  • 5 Pascher A, Neuhaus P. Bile duct complications after liver transplantation. Transpl Int 2005; 18: 627-642
  • 6 Williams ED, Draganov PV. Endoscopic management of biliary strictures after liver transplantation. World J Gastroenterol 2009; 15: 3725-3733
  • 7 Sauer P, Chahoud F, Gotthardt D et al. Temporary placement of fully covered self-expandable metal stents in biliary complications after liver transplantation. Endoscopy 2012; 44: 536-538
  • 8 Traina M, Tarantino I, Barresi L et al. Efficacy and safety of fully covered self-expandable metallic stents in biliary complications after liver transplantation: A preliminary study. Liver Transpl 2009; 15: 1493-1498
  • 9 Liu X, Zhu S, Wang T et al. Paclitaxel modulates TGFβ signaling in scleroderma skin grafts in immunodeficient mice. PLoS Med 2005; 2: e354
  • 10 Scheller B, Hehrlein C, Bocksch W et al. Treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. N Engl J Med 2006; 355: 2113-2124