Endoscopic therapy for gastrointestinal bleeding after liver transplantation

• Main Authors: LIU Bo, LIU Yingdi, SUN Guohui
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2016-10-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=7755
• ISSN: 1001-5256; 1001-5256

Objective To investigate the clinical effect of endoscopic therapy for patients with esophagogastric variceal bleeding (EVB) after liver transplantation. Methods A retrospective analysis was performed for the clinical data of 8 patients who experienced EVB after liver transplantation and underwent endoscopic therapy, especially endoscopic features. The clinical outcome was evaluated, including hemostasis rate, change in varicose veins after treatment, and short-term recurrence and bleeding rate. Results The eight patients had a mean age of 55.00(44.75-61.50) years, and the mean time from liver transplantation to bleeding was 71.50(18.75-107.25) months. As for primary diseases, 6 patients had hepatitis B cirrhosis (among whom one patient each was complicated by liver cancer, alcoholic cirrhosis, and acute liver necrosis, and three were complicated by subacute liver necrosis), one had hepatitis C cirrhosis, and one had unexplained liver cirrhosis. Of all patients, 2 underwent sclerotherapy, 6 underwent endoscopic variceal ligation, and 6 underwent tissue adhesive treatment. The endoscopic therapy achieved successful hemostasis in all patients. No patients experienced rebleeding at discharge or the 12-month follow-up visit. One patient underwent selective endoscopic therapy due to the recurrence of varices. Conclusion Gastrointestinal bleeding remains a serious complication after liver transplantation. Besides antiviral therapy, the presence of varices should be closely monitored.