Efficacy of sirolimus on ischemic-type biliary lesions after liver transplantation

Objective: To explore and summarize the effect of sirolimus on ischemic-type biliary lesions (ITBL) after liver transplantation. Methods: A retrospective study was carried out on 52 patients using sirolimus for biliary complications after liver transplantation from 2004 to 2016 in our hospital. Serum alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin, glutamyl endopeptidase, and alkaline phosphatase (ALP) after the surgery, and six months later were recorded and analyzed, the 1- and 3-year graft survival rates were analyzed. Results: Serum alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin, glutamyl endopeptidase, and alkaline phosphatase (ALP) significantly increased in 52 patients with ITBL. Among the patients with ITBL, 30 patients were treated with sirolimus after the surgery, and six months later, the above indices significantly improved in the treatment group compared with the control group. The patients in control group were treated by traditional plan, tacrolimus based treatment without sirolimus. The 1- and 3-year graft survival rates in the sirolimus group were higher than those in the control group. Moreover, the second transplantation rate was lower in the treated group. The blood lipid level was higher in the sirolimus group compared with the control group. Conclusion: Sirolimus is clinically effective for management of ITBL. Until a better treatment is found, sirolimus is worth attempting, and secondary transplantation may be avoided.