Long-term follow-up of biliary complications after adult right-lobe living donor liver transplantation.
BACKGROUND
Long-term biliary complications after living donor liver transplantation (LDLT) are not well described in the literature. This study was undertaken to determine the long-term impact of biliary complications after adult right-lobe LDLT.


METHODS
This retrospective review analyzed an 11-yr experience of 344 consecutive right-lobe LDLTs with at least two yr of follow-up.


RESULTS
Biliary leaks occurred in 50 patients (14.5%), and strictures occurred in 67 patients (19.5%). Cumulative biliary complication rates at 1, 2, 5, and 10 yr were 29%, 32%, 36%, and 37%, respectively. Most early biliary leaks were treated with surgical drainage (N = 29, 62%). Most biliary strictures were treated first with endoscopic retrograde cholangiography (42%). There was no association between biliary strictures and the number of ducts (hazard ratio [HR] 1.017 [0.65-1.592], p = 0.94), but freedom from biliary stricture was associated with a more recent era (2006-2010) (HR 0.457 [0.247-0.845], p = 0.01). Long-term graft survival did not differ between those who had or did not have biliary complications (66% vs. 67% at 10 yr).


CONCLUSIONS
Biliary strictures are common after LDLT but may decline with a center's experience. With careful follow-up, they can be successfully treated, with excellent long-term graft survival rates.
Baylor University Medical Center, Dallas, TX, USA.
Peter T W
PT
Kim
Max
M
Marquez
James
J
Jung
David
D
Cavallucci
Eberhard L
EL
Renner
Mark
M
Cattral
Paul D
PD
Greig
Ian D
ID
McGilvray
Markus
M
Selzner
Anand
A
Ghanekar
David R
DR
Grant
D000328:Adult; D001660:Biliary Tract Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
biliary complications; living donor liver transplant; long-term complications