title: Biliary complications after liver transplantation.
abstract: Biliary complications (BCs) remain one of the most outstanding factors influencing long-term results after orthotopic liver transplantation. The authors carried out a systematic overview of 1720 papers since 2008, and focused on 45 relevant ones. Among 14,411 transplanted patients the incidence of BCs was 23%. Biliary leakage occurred in 8.5%, biliary stricture in 14.7%, mortality rate was 1-3%.
  
  
  METHODS
  preoperative sodium level; p = 0.037, model of end-stage liver disease score >25; p = 0.048, primary sclerosing cholangitis; p = 0.001, malignancy; p = 0.026, donor age >60, macrovesicular graft steatosis; p = 0.001, duct-to-duct anastomosis; p = 0.004, long anhepatic phase; p = 0.04, cold ischemic time >12 h; p = 0.043, use of T-tube; p = 0.032, insufficient flush of bile ducts; p = 0.001, acute rejection; p = 0.003, cytomegalovirus infection; p = 0.004 and hepatic artery thrombosis; p = 0.001. The management was surgical in case of biliary leakage, and interventional radiology or endoscopic retrograde cholangiopancreatography in case of biliary stricture. Mapping of miRNA profile is a new field of research. Nemes-Doros score is a useful tool in the estimation of hepatic artery thrombosis. Management of BCs requires a multidisciplinary expert team.
authors.affiliation: Division of Transplantation, Institute of Surgery, Clinical Centre, University of Debrecen, Moricz Zs. krt. 22, Debrecen, H-4032, Hungary.
authors.forename: Balázs
authors.initials: B
authors.lastname: Nemes
authors.forename: György
authors.initials: G
authors.lastname: Gámán
authors.forename: Attila
authors.initials: A
authors.lastname: Doros
mesh_terms: D001649:Bile Duct Diseases / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: ERCP; ITBL; biliary complication; hepatitis C; intervention; liver transplantation; overview; radiology; surgery; vanishing bile duct