Premium
Long‐term follow‐up of biliary complications after adult right‐lobe living donor liver transplantation
Author(s) -
Kim Peter T.W.,
Marquez Max,
Jung James,
Cavallucci David,
Renner Eberhard L.,
Cattral Mark,
Greig Paul D.,
McGilvray Ian D.,
Selzner Markus,
Ghanekar Anand,
Grant David R.
Publication year - 2015
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12538
Subject(s) - medicine , liver transplantation , hazard ratio , surgery , complication , retrospective cohort study , biliary drainage , cholangiography , lobe , transplantation , biliary tract , biliary fistula , gastroenterology , fistula , confidence interval , anatomy
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 LDLT s 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.