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27 August 2021: Original Paper

Can Microscopic Biliary Reconstruction Reduce Biliary Complication Rate in ABO-Incompatible Adult Living Donor Liver Transplantation?

Yu-Cheng Lin BCDEF , Tsan-Shiun Lin ABCDF , Chih-Che Lin ABCDEF , Yueh-Wei Liu B , Shih-Ho Wang B , Yi-Ju Wu B , Wei-Feng Li B , Yu-Hung Lin BCDEF , Ting-Lung Lin B , Yi-Chia Chan B , Cheng-Hsi Yeh B , Chih-Chi Wang B , Chao-Long Chen ABDEF , Chee-Chien Yong ABCDEF*

DOI: 10.12659/AOT.931963

Ann Transplant 2021; 26:e931963

Table 5 Univariate analysis of the risk factors for biliary complication in 30 ABO-incompatible patients.

Biliary complication (n=12)No-biliary complication (n=18)p Value
Age (years)53.5±7.5954.2±7.630.81
Male/Female11/114/40.32
BMI24.5 (21–34)26.5 (20–34)0.28
Disease0.21
 HBV3 (25%)12 (66.7%)
 HCV2 (16.7%)2 (11.1%)
 PBC1 (8.3%)0
 Alcoholic4 (33.3%)3 (16.7%)
 Others2 (16.7%)1 (5.6%)
HCC7 (58.3%)10 (55.6%)0.88
MELD11.5 (6–21)10.5 (6–20)0.71
GRWR (%)0.94±0.20%0.83±0.20%0.15
Graft type0.22
 Right lobe6 (50%)13 (72.2%)
 Left lobe6 (50%)5 (27.8%)
Biliary reconstruction type0.23
 Duct to duct12 (100%)16 (88.9%)
 Duct to jejunum02 (11.1%)
Warm ischemic time45.5 min (30–199)37 min (27–71)0.71
Cold ischemic time41.5 min (25–54)42.5 min (27–74)1.00
Operation time599 min (542–754)600 min (431–778)1.00
Blood loss2675 ml (600–6300)2400 ml (300–12000)0.71
ABO blood barrier0.50
 Anti-A4 (33.3%)7 (38.9%)
 Anti-B3 (25%)7 (38.9%)
 Anti-A/B5 (41.7%)4 (22.2%)
Initial IgM1:32 (1:4–1:512)1:32 (1:8–1:1024)1.00
Initial IgG1:128 (1:8–1:2048)1:128 (1:8–1:2048)1.00
Post LT IgM1:6 (0–1:16)1:4 (1:1–1:128)0.71
Post LT IgG1:48 (1:1–1:256)1:16 (1:2–1:256)0.26
IA Rebound (n)4 (33.3%)4 (22.2%)0.44
Initial CD3+ (%)63 (22–82)66 (43–79)1.00
Initial CD19+ (%)22 (7–70)15 (5–31)0.19
ACR within 1 year3 (25%)4 (22.2%)0.86
ABOi – ABO incompatiable; PBC – primary biliary cholangitis; HCC – hepatocellular carcinoma; MELD score – model for end-stage liver disease; GRWR – graft-to-recipient weight ratio; LT – liver transplantation; IA – isoagglutinin; ACR – acute cellular rejection.

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358