3 years ago

Patient and Graft Survival: Biliary Complications after Liver Transplantation

Biliary complications (BC) effect upto to 34% of liver transplant (LT) recipients and are a major source of morbidity and cost. This is a 13-year review of BC after LT at a tertiary care center. Study Design Single center retrospective review of prospective database to assess BC in adult (≥18yrs) LT recipients over a 13 period (2002-2014). BC were divided into three sub-groups: leak alone(L), stricture alone(S), and both leak and strictures(LS). Controls (no BC) were used for comparison. Results 1041 adult LT were performed during the study period, of which 239(23%) developed BC:55(23%)L, 148(62%)S, and 36(15%)LS. 102(43%) were early (<30d). Surgical revision was required in 42(17%) (30L, 10LS, 2S) while remaining 197(83%) were managed non-surgically(25L, 26LS, 146S) with an average of 4.2 interventions/patient. One-,3-, and 5-year overall patient and graft survival was significantly reduced in patients with bile leaks (L)(84%,71%,68% and 76%,67%,64% respectively) compared to controls (90%,84%,78% and 88%,81% and 76% respectively(p<0.05). BC patients had higher incidence of cholestatic liver disease(CLD), pre-LT bilirubin, higher use of T tubes, DCD donor grafts, and rates of acute rejection (p<0.05). BC patients had longer ICU and hospital stays and higher rates of 30-and 90-day readmission(p<0.01). Multivariate analysis identified CLD, Roux-en-Y anastomosis, donor–risk-index(DRI)>2, and T-tubes as independent BC predictors Conclusion BC after LT can significantly decrease patient and graft survival. Careful donor and recipient selection and attention to anastomotic technique can reduce BC and improve outcomes.

Publisher URL: www.sciencedirect.com/science

DOI: S1072751518300206

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.