title: Impact of graft steatosis on the post-transplantation biliary complications for living donor liver transplant recipients in China.
abstract: OBJECTIVE
  After living donor liver transplantation (LDLT), the prevalence of complications related to the biliary system is 6-35%. In spite of great improvements in both surgical techniques and postoperative and long-term medical treatment, the biliary complications are still considered a relatively high risk for LDLT. The aim of this retrospective study was to analyze the incidence of biliary complications and identify predisposing risk factors.
  
  
  METHODS
  The clinical and follow-up data of 175 adult patients receiving LDLT (right lobe or left lobe) between 2002 and December 2008 were collected and retrospectively analyzed. Patients were divided into 2 groups: with biliary complications (n=30) and without biliary complications (n=145).
  
  
  RESULTS
  Thirty patients (17.1%) had post-transplantation biliary complications. Eight patients (4.6%) were diagnosed with bile leakage, while 24 patients (13.7%) developed biliary stricture. Percentage of steatosis of the graft and hepatic artery thrombosis after LDLT were two factors upon univariate analysis (p=0.034, p=0.01, respectively). In multivariate logistic analysis, 20-50% macrovesicular steatosis emerged as a new defined risk factor by us (p=0.001). There was no difference in patient survival rate in different groups and sorts of graft steatosis (p>0.05).
  
  
  CONCLUSIONS
  We consider that using a graft with macro-vesicular steatosis in 20-50% should be put on the table carefully, balancing both sides of positive and negative.
authors.affiliation: Department of Liver and Vascular Surgery, Sichuan University, Sichuan Province, China.
authors.forename: Hong-Yu
authors.initials: HY
authors.lastname: Li
authors.forename: Yong-Gang
authors.initials: YG
authors.lastname: Wei
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Lv-Nan
authors.initials: LN
authors.lastname: Yan
authors.forename: Tian-Fu
authors.initials: TF
authors.lastname: Wen
authors.forename: Ji-Chun
authors.initials: JC
authors.lastname: Zhao
authors.forename: Ming-Qing
authors.initials: MQ
authors.lastname: Xu
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Wang
authors.forename: Yu-Kui
authors.initials: YK
authors.lastname: Ma
authors.forename: Jia-Yin
authors.initials: JY
authors.lastname: Yang
mesh_terms: D000328:Adult; D001660:Biliary Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D002681:China / Q000453:epidemiology; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications*