Sánchez Cabús Santiago, Calatayud David, García-Roca Raquel, Ferrer Joana, Martí Josep, Navasa Miquel, Rimola Antoni, Fondevila Constantino, Fuster José, García-Valdecasas Juan Carlos
Unidad de Cirugía Hepatobiliopancreática y Trasplante, Hospital Clínic de Barcelona, Barcelona, España.
Cir Esp. 2013 Jan;91(1):17-24. doi: 10.1016/j.ciresp.2012.07.012. Epub 2012 Oct 5.
Living donor liver transplantation (LDLT) is an effective treatment for patients with terminal chronic liver disease, despite the high incidence of biliary complications. The objective is to evaluate the results and long-term impact of biliary complications after THDV.
From 2000 to 2010, 70 right lobe LDLT were performed. Biliary complications (leakage and stenosis) of the 70 LDLT recipients were collected prospectively and analyzed retrospectively.
A total of 39 patients (55.7%) had some type of biliary complication. Twenty nine presented a leak, and of these, 14 subsequently developed a stricture. In addition, 10 patients had a stenosis without prior leakage. The median time to onset of stenosis was almost a year. Patients with previous biliary leakage were more likely to develop stenosis (58% vs. 29.5% at 5 years, P=.05). With a median follow up of 80 months, 70.8% of patients were successfully treated by interventional radiology. After excluding early mortality, there were no differences in survival according to biliary complications. A decrease of biliary complications was observed in the last 35 patients compared with the first 35.
LDLT is associated with a high incidence of biliary complications. However, long-term outcome of patients is not affected. After a median follow-up time of nearly seven years, no differences were found in survival according to the presence of biliary complications.
