Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 30;112(5):znae321.
doi: 10.1093/bjs/znae321.

Consensus classification of biliary complications after liver transplantation: guidelines from the BileducTx meeting

Hannah Esser  1 , Iris E M de Jong  2   3 , Floris M Roos  4 , Christina Bogensperger  1 , Stefan M Brunner  5 , Benno Cardini  1 , Philipp Dutkowski  6 , Hasan Eker  7 , Sofia Ferreira-Gonzalez  8 , Stuart J Forbes  9 , Peter J Friend  10 , Yiliam Fundora  11 , Henrik Junger  5 , Felix J Krendl  1 , Paulo N Martins  12 , Vincent E de Meijer  13 , Rupert Oberhuber  1 , Gabriel C Oniscu  14 , Damiano Patrono  15 , Robert J Porte  16 , Thomas Resch  1 , Hatem Sadik  10 , Andrea Schlegel  17 , Nicola De Stefano  15 , Mathias Vidgren  14 , Christopher J E Watson  18 , Annemarie Weißenbacher  1 , Stefan Schneeberger  1
Affiliations

Consensus classification of biliary complications after liver transplantation: guidelines from the BileducTx meeting

Hannah Esser et al. Br J Surg. .
No abstract available

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Factors contributing to the development of post-transplant cholangiopathy During the procurement and transplant process cholangiocytes are exposed to ischaemia-mediated injury resulting in damage to mitochondria and the subsequent release of reactive oxygen species (ROS). If ROS can’t be scavenged by antioxidants, cholangiocytes can become apoptotic or necrotic and contribute to inflammatory processes by releasing cytokines a. The majority of (distal) cholangiocytes suffers profound damage during the liver transplant process. Lost surface epithelium needs to be repaired by the surviving cholangiocyte population. The regenerative capacity of the remaining cholangiocytes is negatively impacted by factors such as cellular senescence, an irreversible cell cycle arrest preventing cholangiocyte proliferation and contributing to inflammation b, and local hypoxia caused by damage to the peribiliary vascular plexus c. If the restoration of the surface epithelium is impaired, increased bile toxicity and collapse of the bicarbonate umbrella aggravate biliary injury d, triggering an ongoing wound-healing response which results in fibrosis and stricturing.
Fig. 2
Fig. 2
Classification of biliary complications following liver transplantation
Fig. 3
Fig. 3
Suggested classification for grading of biliary complications following liver transplantation
See this image and copyright information in PMC

References

    1. Samuel D et al. EASL clinical practice guidelines on liver transplantation. Jou Hepatol 2016; 81:1040–1086 - PubMed
    1. Mourad MM, Liossis C, Gunson BK, Mergental H, Isaac J, Muiesan P et al. Etiology and management of hepatic artery thrombosis after adult liver transplantation. Liver Transpl 2014;20:713–723 - PubMed
    1. Olthoff KM, Kulik L, Samstein B, Kaminski M, Abecassis M, Emond J et al. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver Transpl 2010;16:943–949 - PubMed
    1. Ploeg RJ, D'Alessandro AM, Knechtle SJ, Stegall MD, Pirsch JD, Hoffmann RM et al. Risk factors for primary dysfunction after liver transplantation–a multivariate analysis. Transplantation 1993;55:807–813 - PubMed
    1. Foley DP, Fernandez LA, Leverson G, Anderson M, Mezrich J, Sollinger HW et al. Biliary complications after liver transplantation from donation after cardiac death donors: an analysis of risk factors and long-term outcomes from a single center. Ann Surg 2011;253:817–825 - PMC - PubMed