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

Lüthold, Samuel; Kaseje, Neema; Jannot Berthier, Anne-Sophie; Mentha, Gilles; Majno, Pietro; Toso, Christian; Belli, Dominique Charles; Mclin, Valérie Anne; Wildhaber, Barbara

doi:10.1111/petr.12363

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Title		Risk factors for early and late biliary complications in pediatric liver transplantation
Authors		Lüthold, Samuel Kaseje, Neema Jannot Berthier, Anne-Sophie Mentha, Gilles Majno, Pietro Toso, Christian Belli, Dominique Charles Mclin, Valérie Anne Wildhaber, Barbara show all authors [1 - 9]
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.
Identifiers		DOI: 10.1111/petr.12363 PMID: 25263826
Full text		Article (Published version) (178 Kb) - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique
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)
Citation (ISO format)		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