Risk factors and prevention of biliary anastomotic complications in adult living donor liver transplantation

Table 1 Demographics of the recipientes

Age (yr)	48.8 ± 14.2
Gender
Male	17
Female	16
Diagnosis
Cholestatic disease	6
Hepatocellular carcinoma	9
Liver cirrhosis	8
Fulminant hepatic failure	5
Others	5
CTP	9.9 ± 3.2
MELD	17.8 ± 7.7
Graft
Right	8
Left	25
GRWR (%)	0.84 ± 0.23
Type of reconstruction
Duct-to-Duct	17
Roux-en-Y	16
Follow-up (mo)	47.2 ± 28.9

CTP: Child-Turcotte-Pugh; MELD: model for end-stage liver disease; GRWR: graft volume/recipient body weight ratio.

Table 2 Preoperative risk factor for biliary anastomotic complications in adult living donor liver transplantation

	Biliary anastomotic complications
	Absent (n = 20)	Present (n = 13)	P value
Age (yr)	50.4 ± 12.8	46.2 ± 16.4	NS
Gender			NS
Male	10	7
Female	10	6
CTP	10.4 ± 3.2	10.0 ± 3.2	NS
MELD	18.5 ± 8.0	16.8 ± 7.4	NS
ABO matching			NS
Identical	15		10
Compatible	2		3
Incompatible	3		0
NAC			0.05
Yes	2	5
No	18	2
Donor age (yr)	38.4 ± 11.6	33.8 ± 13.5	NS

CTP: Child-Turcotte-Pugh; MELD: model for end-stage liver disease; NAC: neoadyuvant chemotherapy; NS: not significant.

Table 3 Intraoperative risk factor for biliary anastomotic complications in adult living donor liver transplantation

	Biliary anastomotic complications
	Absent (n = 20)	Present (n = 13)	P value
WIT (min)	47.8 ± 9.1	46.0 ± 7.7	NS
CIT (min)	61.7 ± 52.9	47.1 ± 32.9	NS
Post PVP (mmHg)	163.2 ± 40.7	182.3 ± 42.5	NS
Graft			NS
Right	4	4
Left	16	9
GRWR (%)	0.834 ± 0.211	0.843 ± 0.261	NS
Type of reconstruction			NS
Duct-to-Duct	11	6
Roux-en-Y	9	7
Number of bile duct			NS
Single	16	8
Multiple	4	5

WIT: warm ischemia time; CIT: cold ischemia time; PVP: portal venous pressure; GRWR: graft volume/recipient body weight ratio; NS: not significance.

Table 4 Postoperative risk factor for biliary anastomotic complications in adult living donor liver transplantation

	Biliary anastomotic complications
	Absent (n = 20)	Present (n = 13)	P value
HAT			NS
Yes	0	0
No	20	13
ACR			NS
Yes	10	6
No	10	7
CMV			NS
Yes	10	6
No	10	7
Bacteremia			0.006
Yes	2	7
No	18	6

HAT: hepatic arterial thrombosis; ACR: acute cellular rejection; CMV: cytomegalovirus; NS: not significant.

Table 5 Incidence of biliary anastomotic complications according to type of biliary reconstructions

		Stricture
	Leakage	Leakage (-)	Leakage (+)
Duct-to-Duct (n = 17)	5	1	3
Roux-en-Y (n = 16)	6	1	0

Table 6 Incidence of bacteremia associated with biliary anastomotic complications according to type of biliary reconstructions

	Absent	Present	P value
Duct-to-Duct (n = 6)	6	0
Roux-en Y (n = 7)	2	5	0.008

Table 7 Incidence of biliary anastomotic complications according to type of external stent tubes in Duct-to-Duct anastomoses

	Absent	Present	P value
Straight tube (n = 12)	6	6
T tube (n = 5)	5	0	0.049