title: Ratio of hepatic arterial flow to recipient body weight predicts biliary complications after deceased donor liver transplantation.
abstract: OBJECTIVE
  Adequate hepatic arterial (HA) flow to the bile duct is essential in liver transplantation. This study was conducted to determine if the ratio of directly measured HA flow to weight is related to the occurrence of biliary complications after deceased donor liver transplantation.
  
  
  METHODS
  A retrospective review of 2684 liver transplants carried out over a 25-year period was performed using data sourced from a prospectively maintained database. Rates of biliary complications (biliary leaks, anastomotic and non-anastomotic strictures) were compared between two groups of patients with HA flow by body weight of, respectively, <5 ml/min/kg (n = 884) and ≥5 ml/min/kg (n = 1800).
  
  
  RESULTS
  Patients with a lower ratio of HA flow to weight had higher body weight (92 kg versus 76 kg; P < 0.001) and lower HA flow (350 ml/min versus 550 ml/min; P < 0.001). A lower ratio of HA flow to weight was associated with higher rates of biliary complications at 2 months, 6 months and 12 months (19.8%, 28.2% and 31.9% versus 14.8%, 22.4% and 25.8%, respectively; P < 0.001).
  
  
  CONCLUSIONS
  A ratio of HA flow to weight of < 5 ml/min/kg is associated with higher rates of biliary complications. This ratio may be a useful parameter for application in the prevention and early detection of biliary complications.
authors.affiliation: Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX, USA.
authors.forename: Peter T W
authors.initials: PT
authors.lastname: Kim
authors.forename: Giovanna
authors.initials: G
authors.lastname: Saracino
authors.forename: Linda
authors.initials: L
authors.lastname: Jennings
authors.forename: Michael
authors.initials: M
authors.lastname: Ramsay
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: McKenna
authors.forename: Giuliano
authors.initials: G
authors.lastname: Testa
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Anthony
authors.forename: Nicholas
authors.initials: N
authors.lastname: Onaca
authors.forename: Richard M
authors.initials: RM
authors.lastname: Ruiz
authors.forename: Robert M
authors.initials: RM
authors.lastname: Goldstein
authors.forename: Marlon F
authors.initials: MF
authors.lastname: Levy
authors.forename: Goran B
authors.initials: GB
authors.lastname: Klintmalm
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000209:etiology*; D001660:Biliary Tract Diseases / Q000209:etiology*; D001783:Blood Flow Velocity; D001835:Body Weight; D002779:Cholestasis / Q000209:etiology; D005260:Female; D006499:Hepatic Artery / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013781:Texas; D066027:Transplant Recipients; D016896:Treatment Outcome; D055815:Young Adult