title: Graft macrosteatosis and time of T-tube removal as risk factors for biliary strictures after liver transplantation.
abstract: Biliary strictures (BS) remain a significant problem following liver transplantation (LT), representing an important cause of morbidity. The purpose of this follow-up study was to evaluate the incidence and risk factors associated with BS after LT. From 2001 to 2009, 244 consecutive patients underwent LT at our center. Multiple donor and recipient variables were collected for each patient. Exclusion criteria were hepaticojejunostomy, living-donor LT, and follow-up less than three months. We reviewed 177 patients, all of whom underwent an end-to-end choledochocholedochostomy and T-tube placement. BS occurred in 23% of patients. Multivariate analysis revealed that graft macrovesicular steatosis >25% (p = 0.05, OR 3.38) and time of T-tube removal less than six months (p = 0.02, OR 2.53) were independent risk factors for BS. Biliary strictures did not affect patient and graft survival. Donor macrovesicular steatosis represents a risk factor for BS, contributing to liver damage through a reduction in hepatic blood flow. Time of T-tube removal seems to play a role in the development of BS, although it is unclear whether it represents the cause or the consequence of the development of BS.
authors: Gastroenterology Department of Clinical Medicine, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors: Barbara
authors: B
authors: Lattanzi
authors: Quirino
authors: Q
authors: Lai
authors: Nicola
authors: N
authors: Guglielmo
authors: Valerio
authors: V
authors: Giannelli
authors: Manuela
authors: M
authors: Merli
authors: Michela
authors: M
authors: Giusto
authors: Fabio
authors: F
authors: Melandro
authors: Stefano
authors: S
authors: Ginanni Corradini
authors: Gianluca
authors: G
authors: Mennini
authors: Pasquale Bartolomeo
authors: PB
authors: Berloco
authors: Massimo
authors: M
authors: Rossi
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001660:Biliary Tract Diseases / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D020878:Device Removal / Q000009:adverse effects*; D005234:Fatty Liver / Q000150:complications* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008107:Liver Diseases / Q000150:complications* / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate