BACKGROUND: Despite recent advances in organ preservation, immunosuppression, and surgical techniques, the biliary tree is still considered the Achilles' heel of liver transplantation. The aim of this study is to retrospectively analyze the incidence of biliary complications and identify risk factors that might predispose to the development of biliary problems. METHODS: From January 2004 to December 2007, 117 consecutive liver transplantations were retrospectively analyzed for the development of biliary complications by the review of medical records. Patients were divided into group 1 with biliary complications (n = 43) and group 2 without biliary complications (n = 74). RESULTS: The overall biliary complication rate was 36.8% (leakage 6% and stricture 30.8%). Univariate analysis indicated that significant predictors of biliary complications were the time interval between portal and arterial reperfusion (p = 0.037) and macrovacuolar steatosis of the graft > 25% (p = 0.004). Stepwise logistic regression model demonstrated that a macrosteatosis of the graft > 25% (OR = 5.21 CI 95% [1.79-15.15], p = 0.002) was the only independent risk factor predicting biliary complications after liver transplantation. No differences in patient's and graft's survival were noted between the two groups. CONCLUSION: According to our experience, transplanting a liver with > 25% of steatosis is a risk factor for the development of biliary complication.
BACKGROUND: Despite recent advances in organ preservation, immunosuppression, and surgical techniques, the biliary tree is still considered the Achilles' heel of liver transplantation. The aim of this study is to retrospectively analyze the incidence of biliary complications and identify risk factors that might predispose to the development of biliary problems. METHODS: From January 2004 to December 2007, 117 consecutive liver transplantations were retrospectively analyzed for the development of biliary complications by the review of medical records. Patients were divided into group 1 with biliary complications (n = 43) and group 2 without biliary complications (n = 74). RESULTS: The overall biliary complication rate was 36.8% (leakage 6% and stricture 30.8%). Univariate analysis indicated that significant predictors of biliary complications were the time interval between portal and arterial reperfusion (p = 0.037) and macrovacuolar steatosis of the graft > 25% (p = 0.004). Stepwise logistic regression model demonstrated that a macrosteatosis of the graft > 25% (OR = 5.21 CI 95% [1.79-15.15], p = 0.002) was the only independent risk factor predicting biliary complications after liver transplantation. No differences in patient's and graft's survival were noted between the two groups. CONCLUSION: According to our experience, transplanting a liver with > 25% of steatosis is a risk factor for the development of biliary complication.
Authors: Andrew D Posner; Samuel T Sultan; Norann A Zaghloul; William S Twaddell; David A Bruno; Steven I Hanish; William R Hutson; Laci Hebert; Rolf N Barth; John C LaMattina Journal: Clin Transplant Date: 2017-07-13 Impact factor: 2.863
Authors: Lisa M McElroy; Amna Daud; Ashley E Davis; Brittany Lapin; Talia Baker; Michael M Abecassis; Josh Levitsky; Jane L Holl; Daniela P Ladner Journal: Am J Surg Date: 2014-07-18 Impact factor: 2.565
Authors: Arun P Palanisamy; D J Taber; A G Sutter; S N Nadig; J E Dowden; J W McGillicuddy; P K Baliga; K D Chavin Journal: J Gastrointest Surg Date: 2014-10-16 Impact factor: 3.452
Authors: Moustafa Mabrouk Mourad; Abdullah Algarni; Christos Liossis; Simon R Bramhall Journal: World J Gastroenterol Date: 2014-05-28 Impact factor: 5.742
Authors: Barbara Lattanzi; Peter Ott; Allan Rasmussen; Karen Raben Kudsk; Manuela Merli; Gerda Elisabeth Villadsen Journal: In Vivo Date: 2018 Nov-Dec Impact factor: 2.155