Is absorb stent available for recurrent anastomotic venous or biliary stricture after living liver donor transplantation?

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K10347
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Radiation science
• Research Institution: Kyoto College of Medical Science
• Principal Investigator: Shibata Toshiya 京都医療科学大学, 医療科学部, 教授 (60162632)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 生体肝移植 / LDLT / 吻合部狭窄 / IVR / intervention / 可溶性ドレナージカテーテル

Outline of Final Research Achievements

Interventional radiology, such as percutaneous balloon dilatation or stent placement is an effective treatment for anastomotic venous or biliary stricture after living liver donor transplantation. However, there are a few cases where recurrent stricture occurs after repeated interventions. The purpose of our study was initially to apply absorb stent for the treatment recurrent anastomotic stricture. But off-label use of coronary absorb stent was difficult. So, animal studies using a Flexima catheter which is a biliary drainage catheter with dissolution of the catheter tip were performed. In the animal studies, dissolution of the catheter tip and patency of the wider lumen was achieved. A dissolve biliary catheter can be used for recurrent biliary stricture after living liver donor transplantation in the future.

Free Research Field

医歯薬学

Academic Significance and Societal Importance of the Research Achievements

小児胆道閉鎖症例では、左葉生体肝移植が施行されることが多く胆管吻合は胆管-空腸吻合が行われる。胆管-空腸吻合後の術後胆管狭窄に対しては一般的にPTBD（percutaneous transhepatic biliary drainage）が施行される。PTBDルートでinner drainageが可能となっても、ドレナージカテーテルは体外にでた状態で日常生活を送ることになり、小児患者にとって苦痛が大きい。将来可溶性ドレナージチューブが治療に用いられると、より容易にカテーテルフリーの状態が達成できる可能性があり、患者さんのQOL向上に役立つものと考えられる。