title: Liver transplantation across Rh blood group barriers increases the risk of biliary complications.
abstract: BACKGROUND
  Cold ischemia time and the presence of postoperative hepatic arterial thrombosis have been associated with biliary complications (BC) after liver transplantation. An ABO-incompatible blood group has also been suggested as a factor for predisposal towards BC. However, the influence of Rh nonidentity has not been studied previously.
  
  
  METHODS
  Three hundred fifty six liver transplants were performed from 1995 to 2000 at our hospital. BC incidence and risk factors were studied in 345 patients.
  
  
  RESULTS
  Seventy patients (20%) presented BC after liver transplantation. Bile leakage (24/45%) and stenotic anastomosis (21/30%) were the most frequent complications. Presence of BC in Rh-nonidentical graft-host cases (23/76, 30%) was higher than in Rh-identical grafts (47/269, 17%) (P=0.01). BC was also more frequent in grafts with arterial thrombosis (9/25, 36% vs 60/319, 19%; P=0.03) and grafts with cold ischemia time longer than 430 min (26/174, 15% vs 44/171, 26%; P=0.01). Multivariate logistic regression confirmed that Rh graft-host nonidentical blood groups [RR=2(1.1-3.6); P=0.02], arterial thrombosis [RR=2.6(1.1-6.4); P=0.02] and cold ischemia time longer than 430 min [RR=1.8(1-3.2); P=0.02] were risk factors for presenting BC.
  
  
  CONCLUSIONS
  Liver transplantation using Rh graft-host nonidentical blood groups leads to a greater incidence of BC.
authors: Department of Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain. jbusquets@csub.scs.es
authors: Juli
authors: J
authors: Busquets
authors: Jose
authors: J
authors: Castellote
authors: Jaume
authors: J
authors: Torras
authors: Juan
authors: J
authors: Fabregat
authors: Emilio
authors: E
authors: Ramos
authors: Laura
authors: L
authors: Llado
authors: Antonio
authors: A
authors: Rafecas
authors: Esmeralda
authors: E
authors: de la Banda
authors: Juan
authors: J
authors: Figueras
mesh_terms: D000368:Aged; D001649:Bile Duct Diseases / Q000209:etiology*; D001787:Blood Group Incompatibility / Q000150:complications*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology; D008297:Male; D012204:Rh-Hr Blood-Group System; D012307:Risk Factors; D014019:Tissue Donors
chemical_list: D012204:Rh-Hr Blood-Group System