Biliary complications after liver transplantation

B. Nemes, György Gámán, Attila Doros

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Biliary complications (BCs) remain one of the most outstanding factors influencing long-term results after orthotopic liver transplantation. The authors carried out a systematic overview of 1720 papers since 2008, and focused on 45 relevant ones. Among 14,411 transplanted patients the incidence of BCs was 23%. Biliary leakage occurred in 8.5%, biliary stricture in 14.7%, mortality rate was 1-3%. Risk factors: preoperative sodium level; p = 0.037, model of end-stage liver disease score >25; p = 0.048, primary sclerosing cholangitis; p = 0.001, malignancy; p = 0.026, donor age >60, macrovesicular graft steatosis; p = 0.001, duct-to-duct anastomosis; p = 0.004, long anhepatic phase; p = 0.04, cold ischemic time >12 h; p = 0.043, use of T-tube; p = 0.032, insufficient flush of bile ducts; p = 0.001, acute rejection; p = 0.003, cytomegalovirus infection; p = 0.004 and hepatic artery thrombosis; p = 0.001. The management was surgical in case of biliary leakage, and interventional radiology or endoscopic retrograde cholangiopancreatography in case of biliary stricture. Mapping of miRNA profile is a new field of research. Nemes-Doros score is a useful tool in the estimation of hepatic artery thrombosis. Management of BCs requires a multidisciplinary expert team.

Original languageEnglish
Pages (from-to)447-466
Number of pages20
JournalExpert Review of Gastroenterology and Hepatology
Volume9
Issue number4
DOIs
Publication statusPublished - Apr 1 2015

Fingerprint

Hepatic Artery
Liver Transplantation
Pathologic Constriction
Thrombosis
Cold Ischemia
Interventional Radiology
Sclerosing Cholangitis
End Stage Liver Disease
Endoscopic Retrograde Cholangiopancreatography
Cytomegalovirus Infections
Bile Ducts
MicroRNAs
Sodium
Tissue Donors
Transplants
Mortality
Incidence
Research
Neoplasms

Keywords

  • Biliary complication
  • ERCP
  • Hepatitis C
  • Intervention
  • ITBL
  • Liver transplantation
  • Overview
  • Radiology
  • Surgery
  • Vanishing bile duct

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Biliary complications after liver transplantation. / Nemes, B.; Gámán, György; Doros, Attila.

In: Expert Review of Gastroenterology and Hepatology, Vol. 9, No. 4, 01.04.2015, p. 447-466.

Research output: Contribution to journalArticle

Nemes, B. ; Gámán, György ; Doros, Attila. / Biliary complications after liver transplantation. In: Expert Review of Gastroenterology and Hepatology. 2015 ; Vol. 9, No. 4. pp. 447-466.
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