Risk factors and long-term follow-up results for biliary complications after right lobe living donor liver transplantation
10.3760/cma.j.issn.0254 1785.2012.04.005
- VernacularTitle:活体右半供肝移植后胆道并发症的中长期随访研究及危险因素分析
- Author:
Zihong ZHANG
;
Qiang XIA
;
Jianjun ZHANG
;
Qigen LI
;
Ning XU
;
Xiaosong CHEN
;
Feng XUE
;
Longzhi HAN
;
Lei XIA
;
Tianyu XING
;
Xing WANG
;
Yi LUO
;
Conghuan SHEN
;
Zhifeng XI
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Living donors;
Postoperative complications;
Biliary tract;
Risk factors
- From:
Chinese Journal of Organ Transplantation
2012;33(4):208-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective To characterize the clinical course of biliary complications after right lobe living donor liver transplantation (RL-LDLT) and to identify the independent risk factors for biliary strictures.Methods 105 consecutive RL-LDLT recipients operated from April 2007 to April 2010 were followed up. The clinical and operative data were reviewed. The biliary complications and independent risk factors of biliary stricture were studied.Results The median follow-up duration was 49.5 months ranging from 562 to 1675 days.A total of 40 patients (38.1 ％) experienced 11 bile leak episodes (10.4％ ) and 37 (35.2％) biliary stricture episodes after transplantation.Bile leaks occurred at a median time of 9 days ranging from 4 to 54 days after transplantation.For biliary strictures,the occurring time was delayed and scattered wide with a median of 7.6 months ranging from 12 to 790 days after transplantation. Moreover, the biliary stricture incidence in the first year after transplantation was significantly higher than later.The independent risk factors for biliary strictures were CMV infection,bile leaks and bile duct size (≤3 mm).Conclusion The independent risk factors for biliary strictures after RL-LDLT were CMV infection,bile leaks and bile duct size (≤3mm).In order to avoid biliary complications,careful preoperative evaluations are necessary. The dissection of bile ducts should be meticulous to protect its blood supply.CMV infection should be prevented after transplantation.Close surveillance of biliary complications should be given to RL-LDLT recipients during the first year after transplantation.
