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Risk factors for early and late biliary complications in pediatric liver transplantation

Lüthold, Samuel
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Published in Pediatric transplantation. 2014, vol. 18, no. 8, p. 822-30
Abstract BC are a common source of morbidity after pediatric LT. Knowledge about risk factors may help to reduce their incidence. Retrospective analysis of BC in 116 pediatric patients (123 LT) (single institution, 05/1990-12/2011, medium follow-up 7.9 yr). One-, five-, and 10-yr survival was 91.1%, no patient died of BC. Prevalence and risk factors for anastomotic and intrahepatic BC were examined. There were 29 BC in 123 LT (23.6%), with three main categories: 10 (8.1%) primary anastomotic strictures, eight (6.5%) anastomotic leaks, and three (2.4%) intrahepatic strictures. Significant risk factors for anastomotic leaks were total operation time (increase 1.26-fold) and early HAT (<30 days post-LT; increase 5.87-fold). Risk factor for primary anastomotic stricture was duct-to-duct choledochal anastomosis (increase 5.96-fold when compared to biliary-enteric anastomosis). Risk factors for intrahepatic strictures were donor age >48 yr (increase 1.09-fold) and MELD score >30 (increase 1.2-fold). To avoid morbidity from anastomotic BC in pediatric LT, the preferred biliary anastomosis appears to be biliary-enteric. Operation time should be kept to a minimum, and HAT must by all means be prevented. Children with a high MELD score or receiving livers from older donors are at increased risk for intrahepatic strictures.
PMID: 25263826
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Research groups Développement du tube digestif chez les vertébrés (900)
Gastroentérologie et transplantation (pédiatrie) (181)
Hépatologie chirurgicale (327)
Recherche clinique en chirurgie pédiatrique (886)
Transplantation et hépatologie (905)
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LÜTHOLD, Samuel et al. Risk factors for early and late biliary complications in pediatric liver transplantation. In: Pediatric transplantation, 2014, vol. 18, n° 8, p. 822-30. doi: 10.1111/petr.12363 https://archive-ouverte.unige.ch/unige:41719

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Deposited on : 2014-11-12

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