Endoscopic therapy for gastrointestinal bleeding after liver transplantation

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 of55. 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.