Analysis of long term biliary complications and survival of liver transplantation from organ donation after citizen’s death

Abstract

Objective To evaluate the clinical effect, the incidence of postoperative biliary complications and the survival of liver transplantation from Chinese donation after citizen's death (DCD). Methods The clinical characteristics of donors and recipients, survival of allografts and recipients, and postoperative biliary complications of 169 cases of DCD liver transplantation from October 2013 to June 2015 were analyzed retrospectively. Results The overall biliary complication rate was 8.28% (14/169). There were 6 cases of ischemic cholangiopathy [3.55% (6/169)]. In 37 cases receiving donation after brain death liver transplantation, the incidence of biliary complications was 8.11% (3/37), and ischemic biliary disease occurred in 1 case with the incidence being was 2.70%. In 132 cases of donation after cardiac death liver transplantation, biliary complication rate was 8.33% (11/132), and there were 5 cases of ischemic biliary disease with the incidence being 3.79%. There was no significant difference in the incidence of bile duct complications of the recipients between brain death and cardiac death organ donation (P>0.05). The 1-, 2-, and 3-year survival rate of patients and grafts of donation after brain death was 94.5%, 89.2% and 83.7%, and 94.5%, 86.5% and 81.1%, respectively. The 1-, 2-, and 3-year survival rate of patients and grafts of donation after cardiac death was 93.9%, 88.6% and 83.3%, and 91.7%, 86.4% and 80.3%, respectively. There was no significant difference in survival of recipients and grafts between brain death and cardiac death organ donation (P>0.05). The mean warm and cold ischemia time of donation after cardiac death was 13.59 min and 3.32 h respectively. Conclusion The outcome of DCD liver transplantation is satisfactory. The incidence of overall biliary complications and ischemic biliary disease of cardiac death donor liver transplantation was close to that of brain death donor liver transplantation. Key words: Liver transplantation; Donation after cardiac death; Donation after brain death; Complication; Graft survival