title: Treatment of biliary complications after liver transplant: results of a single center.
abstract: Biliary complications are major sources of morbidity after liver transplant due to vulnerable vascularization of the bile ducts. Biliary complications are the "Achilles' heel" of liver transplant with their high incidence, need for repeated and prolonged treatment, and potential effects on graft and patient survival. Although standardization of reconstruction techniques and improvements in immunosuppression and organ preservation have reduced the incidence of biliary complications, in early reports the morbidity rates are 50%, with related mortality rate 25% to 30%. Prophylaxis is a major issue. Although many risk factors (old donor age, marginal graft, prolonged ischemia time, living-donor liver transplant, partial liver transplant, donation after cardiac death, hepatic arterial thrombosis, organ preservation, chronic rejection, and other donor and recipient characteristics) do not directly affect biliary complications, accumulation of the factors mentioned above, should be avoided. However, no accepted standard has been established. Treatment strategy is a subject of debate. Recently, nonoperative treatment of biliary complications have been preferred for diagnosis and therapy, because percutaneous or endoscopic treatment may prevent the need for surgical intervention. In this study, we reviewed our treatment of early and late biliary complications after liver transplant.
authors.affiliation: From the Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Yildirim
authors.forename: Ebru Hatice
authors.initials: EH
authors.lastname: Ayvazoglu Soy
authors.forename: Aydincan
authors.initials: A
authors.lastname: Akdur
authors.forename: Mahir
authors.initials: M
authors.lastname: Kirnap
authors.forename: Fatih
authors.initials: F
authors.lastname: Boyvat
authors.forename: Feza
authors.initials: F
authors.lastname: Karakayali
authors.forename: Adnan
authors.initials: A
authors.lastname: Torgay
authors.forename: Gokhan
authors.initials: G
authors.lastname: Moray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey