Effects of different liver transplantations on postoperative early severe complications in liver failure patients: analysis using Clavien-Dindo classification

Abstract

Objective To evaluate the effects of different liver transplantation approaches on the incidence of postoperative complications in patients with liver failure using Clavien-Dindo classification. Methods Clinical data of 132 patients with liver failure who underwent orthotopic liver transplantation for the first time in Beijing You'an Hospital Affiliated to Capital Medical University from January 2004 to December 2013 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 109 patients were male and 23 female, aged (44±10) years on average. All the patients were divided into the classic group (n=25), classical venous bypass group (n=29) and piggyback group (n=78). Postoperative complications were graded by Clavien-Dindo classification, Postoperative complications of Ⅲb and above were defined as the severe complications early after liver transplantation. The incidence of postoperative complications was compared by Chi-square test. Results The incidence of severe complications early after liver transplantation was 31%(41/132). Grade Ⅲb, Ⅳ and Ⅴ complications were observed in 6, 14 and 21 cases, respectively. The incidence of severe complications early after liver transplantation in the classic, classical bypass and piggyback groups were 52%(13/25), 28%(8/29) and 26%(20/78) , respectively, with significant differences were observed (χ2=6.352, P<0.05). The incidence of severe complications in piggyback group was significant lower than that in classic group (χ2=6.041, P<0.017). Conclusions Different liver transplantation approaches exert effects upon the incidence of postoperative complications in patients with liver failure. The incidence of severe complications early after piggyback liver transplantation is relatively low. Key words: Liver transplantation; Technique of operation; Postoperative complications; Clavien-Dindo classification