Biliary cast syndrome after orthotopic liver transplantation: risk factors and outcome

Introduction: Biliary cast syndrome (BCS) is characterized by the presence of retained lithogenic material within the biliary system causing obstructive cholangitis and subsequently liver damage. BCS remains an unusual complication after orthotopic liver transplantation (OLT). However, BCS after OLT is difficult to treat and may result in retransplantation or death. Our aim was to evaluate the etiology, risk factors and outcome of BCS after OLT. Methods: In a retrospective analysis from 2003 to 2011, we identified liver transplanted patients with BCS diagnosed by endoscopic retrograde cholangiography (ERC) and c…