Biliary Complications After Liver Transplantation: Incidence, Risk Factors and Impact on Patient and Graft Survival.

Published on Mar 1, 2016
· DOI :10.1016/J.TRANSPROCEED.2016.02.033
G.A. Mejía1
Estimated H-index: 1
C. Olarte-Parra1
Estimated H-index: 1
+ 2 AuthorsCarlos Benavides5
Estimated H-index: 5
Abstract Introduction Biliary complications (BC) are one of the most frequent surgical complications after liver transplantation. They include biliary stenosis, leaks, choledocolitiasis and sphincter of Oddi dysfunction. These complications can cause graft dysfunction, retrasplantation, or even death. The purpose of this study was to identify factors related to BC. Materials and Methods The medical records of all adult patients who underwent their first liver transplantation in our institution from 2005 to 2013 were reviewed, and any BC that required management was recorded. Cumulative incidence of BC was estimated using Kaplan-Meier. Patient and graft survival was compared using the log-rank test. The Cox regression model was used to establish associated factors. Results Of the 236 patients who underwent liver transplantation, 41 patients (17.8%) developed BC. Cumulative incidence was 12.9%, 17.2%, and 20%, after 1, 3 and 5 years of the transplantation, respectively. Twenty-six cases of biliary stenosis, 11 of leaks, and 4 of choledocolitiasis were identified. Most patients were managed endoscopically (82.9%). There were no differences in patient or graft survival. Discussion Biliary stenosis is the most frequent BC. Patients with higher risk of BC were of blood type AB ( P P  = .049), or had alcoholic cirrhosis ( P  = .036). The success with the endoscopic treatment reduced the need for surgical interventions. Conclusions The incidence of BC in our institution is comparable with the incidence reported in other institutions. Further prospective studies with larger series of patients are warranted to identify other factors associated with development of BC.
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This Explanation and Elaboration paper supports the STROBE Statement in this issue. It is available online only.
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