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Steatosis of the hepatic graft as a risk factor for post‐transplant biliary complications
Author(s) -
Baccarani Umberto,
Isola Miriam,
Adani Gian L.,
Avellini Claudio,
Lorenzin Dario,
Rossetto Anna,
Currò Giuseppe,
Comuzzi Chiara,
Toniutto Pierluigi,
Risaliti Andrea,
Soldano Franca,
Bresadola Vittorio,
De Anna Dino,
Bresadola Fabrizio
Publication year - 2009
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/j.1399-0012.2009.01128.x
Subject(s) - medicine , liver transplantation , steatosis , risk factor , immunosuppression , univariate analysis , gastroenterology , surgery , complication , incidence (geometry) , transplantation , multivariate analysis , physics , optics
Baccarani U, Isola M, Adani GL, Avellini C, Lorenzin D, Rossetto A, Currò G, Comuzzi C, Toniutto P, Risaliti A, Soldano F, Bresadola V, De Anna D, Bresadola F. Steatosis of the hepatic graft as a risk factor for post‐transplant biliary complications.
Clin Transplant 2009 DOI: 10.1111/j.1399‐0012.2009.01128.x.
© 2009 John Wiley & Sons A/S. Abstract: Background: Despite recent advances in organ preservation, immunosuppression, and surgical techniques, the biliary tree is still considered the Achilles’ heel of liver transplantation. The aim of this study is to retrospectively analyze the incidence of biliary complications and identify risk factors that might predispose to the development of biliary problems. Methods: From January 2004 to December 2007, 117 consecutive liver transplantations were retrospectively analyzed for the development of biliary complications by the review of medical records. Patients were divided into group 1 with biliary complications (n = 43) and group 2 without biliary complications (n = 74). Results: The overall biliary complication rate was 36.8% (leakage 6% and stricture 30.8%). Univariate analysis indicated that significant predictors of biliary complications were the time interval between portal and arterial reperfusion (p = 0.037) and macrovacuolar steatosis of the graft > 25% (p = 0.004). Stepwise logistic regression model demonstrated that a macrosteatosis of the graft > 25% (OR = 5.21 CI 95% [1.79–15.15], p = 0.002) was the only independent risk factor predicting biliary complications after liver transplantation. No differences in patient’s and graft’s survival were noted between the two groups. Conclusion: According to our experience, transplanting a liver with > 25% of steatosis is a risk factor for the development of biliary complication.