The reduction rate of serum C3 following liver transplantation is an effective predictor of non-anastomotic strictures.

PURPOSE

Non-anastomotic biliary strictures (NAS) are considered to be the thorniest complications following liver transplantation (LT). How to predict and adopt specific measures early to minimize the occurrence of it remains unclear. In this study, we aimed to find the relationship between the change rate of serum complement level and NAS.

METHODS

In a series of 232 adult patients who underwent their first LT, serum C3 and C4 concentrations at predetermined time points were collected. The correlation between the change rate of serum complement level following LT and the clinical outcome of NAS was retrospectively studied.

RESULTS

The reduction rate of serum C3 at the 1st day following LT in NAS patients was significantly different from that in non-NAS patients (p < 0.01). Receiver operating characteristic curve analysis demonstrated that the reduction rate of serum C3 is an effective predictor of NAS with an area under curve of 82.5 % (95 % CI 77.0-87.2 %). The reduction rate of C3 in the severe NAS group was significantly higher than that in the mild NAS group and the non-NAS group (p < 0.01).

CONCLUSIONS

Complement activation plays important roles on the progression of NAS. The reduction rate of serum C3 is an effective predictor of NAS.