title: Steatosis of the graft is a risk factor for posttransplantation biliary complications.
abstract: 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 was to retrospectively analyze the incidence of biliary complications and identify predisposing risk factors.
  
  
  METHODS
  From January 2004 to December 2007, 117 consecutive deceased donor liver transplantations were retrospectively analyzed for the development of biliary complications by 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 = .037) and macrovacuolar steatosis of the graft >25% (P = .004). A stepwise logistic regression model demonstrated that >25% macrosteatosis of the graft was the only independent risk factor predicting biliary complications after liver transplantation (odds ratio [OR] = 5.21; CI 95% [1.79-15.15]; P = .002). No differences were noted in patient or graft survival between the 2 groups.
  
  
  CONCLUSIONS
  Transplantation of a liver with >25% steatosis was a risk factor for the development of a biliary complication.
authors.affiliation: Department of Tissue & Organ Transplantation, University Hospital of Udine, Italy. umberto.baccarani@uniud.it
authors.forename: U
authors.initials: U
authors.lastname: Baccarani
authors.forename: G L
authors.initials: GL
authors.lastname: Adani
authors.forename: M
authors.initials: M
authors.lastname: Isola
authors.forename: C
authors.initials: C
authors.lastname: Avellini
authors.forename: D
authors.initials: D
authors.lastname: Lorenzin
authors.forename: A
authors.initials: A
authors.lastname: Rossetto
authors.forename: G
authors.initials: G
authors.lastname: Currò
authors.forename: C
authors.initials: C
authors.lastname: Comuzzi
authors.forename: P
authors.initials: P
authors.lastname: Toniutto
authors.forename: F
authors.initials: F
authors.lastname: Soldano
authors.forename: V
authors.initials: V
authors.lastname: Bresadola
authors.forename: A
authors.initials: A
authors.lastname: Risaliti
authors.forename: F
authors.initials: F
authors.lastname: Bresadola
mesh_terms: D000328:Adult; D000368:Aged; D001659:Biliary Tract / Q000473:pathology*; D005234:Fatty Liver / Q000209:etiology*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors