Risk Factors and Management for Biliary Complications Following Adult Living-Donor Liver Transplantation
Tsukasa Nakamura, Taku Iida, Hidetaka Ushigome, Masafumi Osaka, Koji Masuda, Takehisa Matsuyama, Shumpei Harada, Shuji Nobori, Norio Yoshimura
Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan
Ann Transplant 2017; 22:665-670
Biliary complications (BCs) following liver transplantation are very serious. Nevertheless, it is still uncertain which components influence the incidence of BCs the most.
MATERIAL AND METHODS: A consecutive sample of 74 adult recipients who underwent living-donor liver transplantation were enrolled in this study. BCs that were Clavien-Dindo classification grade II or higher were determined as BCs.
RESULTS: There were 11 out of the 74 recipients who experienced BCs. There were no differences in preoperative background factors between the BCs+ and BCs– group. Unexpectedly, the number of bile duct orifices did not contribute to the BCs (p=0.722). In comparison with the BCs– group, the frequency of post-operative bleeding requiring re-operation was relatively higher (27.3% vs. 7.9%, p=0.0913) and this complication was the only independent risk factor (p=0.0238) for the onset of BCs. Many of the BCs+ recipients were completely treated by endoscopic or radiological intervention (81.8%). However, surgical revision was required for 2 recipients (18.2%).
CONCLUSIONS: Given these results, it is reasonable to believe that definite hemostasis is required to prevent future BCs. In addition, bile duct multiplicity was not associated with BCs.
Keywords: Biliary Tract, Liver Transplantation, Living Donors