Biliary complications in recipients of living donor liver transplantation: A single-centre study

Reginia Nabil Guirguis; Ehab Hasan Nashaat; Azza Emam Yassin; Wesam Ahmed Ibrahim; Shereen A Saleh; Mohamed Bahaa; Mahmoud El-Meteini; Mohamed Fathy; Hany Mansour Dabbous; Iman Fawzy Montasser; Manar Salah; Ghada Abdelrahman Mohamed

doi:10.4254/wjh.v13.i12.2081

Biliary complications in recipients of living donor liver transplantation: A single-centre study

World J Hepatol. 2021 Dec 27;13(12):2081-2103. doi: 10.4254/wjh.v13.i12.2081.

Affiliations

¹ Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt.
² Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt.
³ Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt.
⁴ Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt. ghadaabdelrahman@med.asu.edu.eg.

Abstract

Background: Biliary complications (BCs) after liver transplantation (LT) remain a considerable cause of morbidity, mortality, increased cost, and graft loss.

Aim: To investigate the impact of BCs on chronic graft rejection, graft failure and mortality.

Methods: From 2011 to 2016, 215 adult recipients underwent right-lobe living-donor liver transplantation (RT-LDLT) at our centre. We excluded 46 recipients who met the exclusion criteria, and 169 recipients were included in the final analysis. Donors' and recipients' demographic data, clinical data, operative details and postoperative course information were collected. We also reviewed the management and outcomes of BCs. Recipients were followed for at least 12 mo post-LT until December 2017 or graft or patient loss.

Results: The overall incidence rate of BCs including biliary leakage, biliary infection and biliary stricture was 57.4%. Twenty-seven (16%) patients experienced chronic graft rejection. Graft failure developed in 20 (11.8%) patients. A total of 28 (16.6%) deaths occurred during follow-up. BCs were a risk factor for the occurrence of chronic graft rejection and failure; however, mortality was determined by recurrent hepatitis C virus infection.

Conclusion: Biliary complications after RT-LDLT represent an independent risk factor for chronic graft rejection and graft failure; nonetheless, effective management of these complications can improve patient and graft survival.

Keywords: Bile leak; Biliary complications; Biliary stricture; Graft rejection; Living donor liver transplantation; Mortality; Retrospective analysis; Risk factors.