title: [Biliary complications following orthotopic liver transplantation. The Hungarian experience].
abstract: BACKGROUND
  The authors summarize the characteristics of biliary complications following liver transplantation in the Hungarian liver transplant program. Aims were to analyze the frequency and the types of biliary complications as well as their effect on the patient and graft survival. The authors observed the known risk factors in the Hungarian practice, and they also try to find unknown risk factors for biliary complications. They review the therapy of biliary complications.
  
  
  METHODS
  In the retrospective study, patients were divided into two groups, with and without biliary complication after liver transplantation. These two groups were compared with many factors, and with the survivals. The biliary complication group was divided into two parts: those who had an early and those with a late biliary complication. These two new groups were also compared with the controls. The results are summarized in tables and statistical figures. Categorical variables are evaluated by chi 2 -test, continuous ones are with Levine Test (for homogenicity of means), Student T test and Mann-Whitney U-test. Cumulative survivals are computed with Kaplan-Meier log rank analysis.
  
  
  RESULTS
  Biliary complication appeared in 25% of the patients. The most frequent complications were stenosis (18%), biliary leakage (9%), biliary necrosis (6%), and ischaemic type of biliary lesions (3%). The 5-year survival is worse when biliary complications were diagnosed (55%) than without such a complication (66%). In the biliary complication group the retransplantation rate was higher (15%). The most frequent treatments were interventional radiologic methods (69%), surgical methods (17%), and the ERCP.
  
  
  CONCLUSIONS
  The rate of biliary complications met the international reviews. Risk factors for biliary complications were cholangitis, hepatic artery thrombosis and stenosis, high rate of intraoperative blood transfusions, and acute rejection. Biliary complications frequently associated with the initial poor function of the transplanted graft. Early biliary complications have a negative impact on patient survival, while late complications influence a decreased quality of life. Biliary complications were treated mostly by interventional radiologic procedures.
authors.affiliation: Semmelweis Egyetem, Altalános Orvostudományi Kar, Transzplantációs és Sebészeti Klinika Budapest. nemes@trans.sote.hu
authors.forename: Balázs
authors.initials: B
authors.lastname: Nemes
authors.forename: Gergely
authors.initials: G
authors.lastname: Zádori
authors.forename: Erika
authors.initials: E
authors.lastname: Hartmann
authors.forename: Andrea
authors.initials: A
authors.lastname: Németh
authors.forename: Imre
authors.initials: I
authors.lastname: Fehérvári
authors.forename: Dénes
authors.initials: D
authors.lastname: Görög
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Máthé
authors.forename: Andrea
authors.initials: A
authors.lastname: Dávid
authors.forename: Katalin
authors.initials: K
authors.lastname: Jakab
authors.forename: Eniko
authors.initials: E
authors.lastname: Sárváry
authors.forename: László
authors.initials: L
authors.lastname: Piros
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Tóth
authors.forename: János
authors.initials: J
authors.lastname: Fazakas
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Gerlei
authors.forename: Jeno
authors.initials: J
authors.lastname: Járay
authors.forename: Attila
authors.initials: A
authors.lastname: Doros
mesh_terms: D000328:Adult; D000368:Aged; D001646:Bile; D001656:Biliary Atresia / Q000209:etiology; D001659:Biliary Tract / Q000473:pathology* / Q000503:physiopathology; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D002779:Cholestasis / Q000209:etiology; D003251:Constriction, Pathologic / Q000209:etiology; D005260:Female; D006801:Humans; D006814:Hungary; D007511:Ischemia / Q000209:etiology; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D011788:Quality of Life; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors