Graft macrosteatosis and time of T-tube removal as risk factors for biliary strictures after liver transplantation.

Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE

Original Publication: Copenhagen : Munksgaard,

Postoperative Complications*; Biliary Tract Diseases/*etiology ; Constriction, Pathologic/*etiology ; Device Removal/*adverse effects ; Fatty Liver/*complications ; Liver Diseases/*complications ; Liver Transplantation/*adverse effects; Adult ; Aged ; Anastomosis, Surgical ; Biliary Tract Diseases/epidemiology ; Biliary Tract Diseases/mortality ; Constriction, Pathologic/epidemiology ; Constriction, Pathologic/mortality ; Fatty Liver/mortality ; Female ; Follow-Up Studies ; Humans ; Italy/epidemiology ; Liver Diseases/mortality ; Liver Diseases/surgery ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate

Biliary strictures (BS) remain a significant problem following liver transplantation (LT), representing an important cause of morbidity. The purpose of this follow-up study was to evaluate the incidence and risk factors associated with BS after LT. From 2001 to 2009, 244 consecutive patients underwent LT at our center. Multiple donor and recipient variables were collected for each patient. Exclusion criteria were hepaticojejunostomy, living-donor LT, and follow-up less than three months. We reviewed 177 patients, all of whom underwent an end-to-end choledochocholedochostomy and T-tube placement. BS occurred in 23% of patients. Multivariate analysis revealed that graft macrovesicular steatosis >25% (p = 0.05, OR 3.38) and time of T-tube removal less than six months (p = 0.02, OR 2.53) were independent risk factors for BS. Biliary strictures did not affect patient and graft survival. Donor macrovesicular steatosis represents a risk factor for BS, contributing to liver damage through a reduction in hepatic blood flow. Time of T-tube removal seems to play a role in the development of BS, although it is unclear whether it represents the cause or the consequence of the development of BS.
(© 2013 John Wiley & Sons A/S.)

Date Created: 20130508 Date Completed: 20140114 Latest Revision: 20130604

20221213

10.1111/ctr.12124

23647461