Abstract
Adult living-donor liver transplantation (ALDLT) has a high rate of biliary complications (BC). We identified risk factors that correlate with biliary complications by combining data from two European centers. 121 ALDLT right lobe recipients at two centers between March 2001 and June 2012 were reviewed. Patient and graft survival at 1, 3, and 5 years were 84.3%, 78.3%, 69.3% and 78.5%, 72.3%, 65% respectively. Biliary reconstructions were performed using either duct-to-duct (DD) or Roux-en-Y hepaticojejunostomy and were sub classified by anatomic type, number of anastomoses performed, and stent use. 65 donors presented 1 biliary duct, 49 and 7 presented 2 and 3 biliary ducts respectively. Prevalence of a biliary leak and/or stricture was 39,6% (73,4 and 26,6% respectively); 8,2% of recipients developed both. Multiple duct and anastomoses, bilioplasty and association of hepatic artery thrombosis had significantly higher incidence of BC. Mortality and graft loss due to BC were 0.03%. Although the incidence of BC is still high, mainly related to more than one biliary ducts or anastomoses in association with bilioplasty, the BC related mortality and graft loss are insignificant.
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