Risk factors of biliary complications following liver transplantation: retrospective analysis of a single centre

Abstract

Background: Despite improvements that have been achieved in surgical techniques and organ preservation, biliary complications remain one of the most serious morbidities following liver transplantation. However, factors related to biliary complications after liver transplantation are not completely understood. The objective of this study was to identify retrospectively possible risk factors of biliary complications following liver transplantation.

Methods: Data on 279 patients who underwent liver transplantation between January 1999 and November 2005 were collected retrospectively. Selected variables from preoperative, intraoperative and postoperative data were first analysed using univariate logistic regression. Filtered factors with p<0.1 in the first step were further investigated to identify factors independently associated with biliary complications following liver transplantation.

Results: The overall incidence of biliary complications was 22.6%. Multivariate regression revealed that biliary cirrhosis (p = 0.038), anhepatic phase time (p = 0.04), and incidence of hepatic artery abnormality (p = 0.001) after transplantation were factors that were significantly related to biliary complications. Use of a T tube for biliary reconstruction and living grafts were not associated with biliary complications following liver transplantation.

Conclusion: This study suggests that further technical refinement-namely, shortening the anhepatic phase duration, shielding the hepatic artery, and refining biliary duct reconstruction-can reduce the incidence of biliary complications following liver transplantation.