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Year 2015 Vol. 23 No 1


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SEE "Belarusian Medical Academy of Post-Graduate Education"1,
ME "The 9th City Clinical Hospital", Minsk2,
The Republic of Belarus

Objectives. To identify the risk factors for the development of biliary complications after orthotopic liver transplantation and to establish whether streptokinase therapy influences on the formation of biliary complications related liver transplantation in donor phase.
Methods. The analysis of medical records and the treatment results of 117 patients, subjected to the orthotopic liver transplantation within the period from April 2008 to September 2012 has been carried out.
Results. The retrospective analysis has shown the streptokinase treatment in the donor phase does not promote the development of anastomotic biliary strictures. A trend toward a later occurrence of anastomotic strictures after the liver transplantation is considered as a positive effect. The number of the nonanastomotic strictures occurred significantly less during Streptokinase treatment, than in the group without streptokinase application 2,2% and 13,6%, retrospectively. In the donor phase univariate regression analysis has shown that streptokinase treatment contributed to the risk reduction of nonanastomotic strictures formation almost by 4 folds. The failure of biliary anastomosis occurred in 6 patients out of 117 patients who had undergone the liver transplantation. All of them received a transplant from donors with brain death to whom streptokinase hadnt been administrated. The average time of failure development 3 (1; 10) days. Anastomotic strictures related with liver transplantation occurred in 17 patients. Incidence of anastomotic strictures occurrence in the main group was comparable to that in the second group. Thus, in the donor phase streptokinase therapy had no effect on the development of anastomotic strictures. In this case, there was a trend to a later occurrence of anastomotic strictures after transplantation.
Conclusion. The results of the study have shown the effectiveness of the prevention of biliary complications after the liver transplantation by intravenous injections of streptokinase with heparin (dose of 1,5 million IU and 25,000 IU, respectively) 15-20 min before flushing in the donor phase.

Keywords: orthotopic liver transplantation, postoperative complication, biliary stricture, streptokinase
p. 85-90 of the original issue
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Address for correspondence:
2100, Respublika Belarus,
g. Minsk, ul. Semashko, d. 8,
UZ "9-ya gorodskaya klinicheskaya bolnitsa",
otdelenie khirurgii
tel. mob.: +375 25 612 71 11,
Sharipov Shohrat
Information about the authors:
Sharipov S.Z. A surgeon of the surgical unit of ME "The 9th Clinical Hospital", Minsk.
Shcherba A.E., PhD, a head of the hepatobiliary surgery and liver transplantation unit of ME "The 9th Clinical Hospital", Minsk.
Pikirenia I.I. PhD, an associate professor, a head of the transplantation chair of SEE "Belarusian Medical Academy of Post-graduate Education".
Hlinnik A.A. PhD, an associate professor of the transplantation chair of SEE "Belarusian Medical Academy of Post-graduate Education".
Fedaruk A.M. MD, a head of hepatology and low-invasive surgery unit of ME "The 9th Clinical Hospital", Minsk.
Korotkov S.V. PhD, a head of the transplantation unit of ME "The 9th Clinical Hospital", Minsk.
Rummo O.O. MD, a Deputy Chief on surgery, head of the RSPC of organ and tissue transplantation of ME "The 9th Clinical Hospital", Minsk.
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