Predisposing factors for biliary complications following liver transplantation.
BACKGROUND
Biliary complications remain a major cause of morbidity and mortality in patients following liver transplantation. We sought to identify possible risk factors predisposing to biliary complications after OLT using duct-to-duct biliary reconstruction.


METHODS
We retrospectively reviewed 5 years of prospectively collected donor and recipient data between April 1999 and April 2004. We evaluated the presence of biliary complications, donor and recipient age, cold ischemia time, hepatic artery thrombosis, non-heart-beating donor (NHBD), and graft steatosis (>30%). The results were compared with a control group of OLT patients without biliary complications.


RESULTS
Among 173 OLT recipients, biliary complications occurred in 28 patients (16.2%), of whom 12 were leaks, 15 strictures, and 1 a nonanastomotic intrahepatic stricture. The mortality following biliary complications was 11%, compared to 6% in the control group.


CONCLUSIONS
Biliary complications remain a persistent problem in OLT. Analysis of risk factors identified hepatic artery thrombosis and steatosis as predisposing factors. With greater experience, NHBD livers may also prove to be at greater risk of biliary complications.
Sanni
A
A
Department of Liver/Renal Transplant, Freeman Hospital, Newcastle upon Tyne, United Kingdom. aliu_oladipupo@yahoo.com
Asher
J
J
Wilson
C
C
Wyrley-Birch
H
H
Vijayanand
D
D
Jaques
B
B
Talbot
D
D
Manas
D
D
D000328:Adult; D015984:Causality; D015331:Cohort Studies; D005705:Gallbladder Diseases / Q000453:epidemiology*; D006801:Humans; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D012189:Retrospective Studies