title: Reduction in bile leaks following adult split liver transplant using a fibrin-collagen sponge: A pilot study.
abstract: BACKGROUND
  Bile leaks are a frequent complication of adult split liver transplantation. We compared surgical complications in patients who had the cut surface of the donor liver treated with a patch to those in whom the cut surface of the liver was treated with fibrin glue.
  
  
  METHODS
  Two consecutive cohorts of 16 patients undergoing adult right lobe split liver transplant were compared. In the first cohort, the liver surface was treated with fibrin glue and in the second the liver surface was treated with TachoSil fibrinogen-thrombin-collagen patches. Post-operative complications were analyzed.
  
  
  RESULTS
  Bile leaks were significantly fewer among patients in whom the cut surface of the liver was treated with fibrin-collagen sponge compared to those where fibrin glue was used on the cut surface: 1/16 (6.25%) vs. 7/16 (43.75%), respectively; p=0.03. There were some differences in biliary anastomotic techniques used in the two groups but 7/8 leaks (87.5%) arose from the cut surface, and only one was from the anastomosis.
  
  
  CONCLUSIONS
  Using a fibrinogen-thrombin-collagen sponge patch may reduce bile leaks from the cut surface of the liver during adult right lobe split liver transplants.
authors.affiliation: Queen Elizabeth Hospital, Birmingham, UK. lucatoti@gmail.com
authors.forename: Luca
authors.initials: L
authors.lastname: Toti
authors.forename: Magdy
authors.initials: M
authors.lastname: Attia
authors.forename: Tommaso Maria
authors.initials: TM
authors.lastname: Manzia
authors.forename: Ilaria
authors.initials: I
authors.lastname: Lenci
authors.forename: Bridget
authors.initials: B
authors.lastname: Gunson
authors.forename: John A C
authors.initials: JA
authors.lastname: Buckels
authors.forename: Darius F
authors.initials: DF
authors.lastname: Mirza
authors.forename: A David
authors.initials: AD
authors.lastname: Mayer
authors.forename: Simon R
authors.initials: SR
authors.lastname: Bramhall
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wigmore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D046148:Donor Selection; D004338:Drug Combinations; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005340:Fibrinogen / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013917:Thrombin / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin