Use of paclitaxel-eluting balloons for endotherapy of anastomotic strictures following liver transplantation

Biliary anastomotic strictures after liver transplantation are a major source of morbidity and graft failure; however, repeated endoscopic therapy has shown variable long-term success rates. Thus the aim of this prospective case series was to evaluate the safety and efficacy of using paclitaxel-eluting balloons in 13 patients requiring treatment for symptomatic anastomotic strictures following liver transplantation. Sustained clinical success-defined as no need for further endoscopic intervention for at least 6 months - was achieved in 12/13 patients (92%). One, two, and three interventions were required in 9 (69%), 1, and 2 patients, respectively (mean number of sessions was 1.46). Mean (+/- SD) bilirubin level dropped from 6.8 (+/- 4.1) mg/dL to 1.4 (+/- 0.9) mg/dL. These promising results justify carrying out a randomized comparative trial to confirm this innovative approach.