Experience using liver transplantation for the treatment of severe bile duct injuries over 20 years in Argentina: results from a National Survey

Abstract

BackgroundBile duct injury (BDI) is a severe complication that may arise during the surgical treatment of benign disease and a few patients will develop end-stage liver disease (ESLD) requiring a liver transplant (LT). ObjectiveAnalyse the experience using LT as a definitive treatment of BDI in Argentina. Patients and MethodsA national survey regarding the experience of LT for BDI. ResultsSixteen out 18 centres reported a total of 19 patients. The percentage of LT for BDI from the total number of LT per period was: 1990–94 = 3.1%, 1995–99 = 1.6%, 2000–04 = 0.7% and 2005–09 = 0.2% (P < 0.001). The mean age was 45.7 ± 10.3 years (range 26–62) and 10 patients were female. The BDI occurred during cholecystectomy in 16 and 7 had vascular injuries. One patient presented with acute liver failure and the others with chronic ESLD. The median time between BDI and LT was 71 months (range 0.2–157). The mean follow-up was 8.3 years (10 months to 16.4 years). Survival at 1, 3, 5 and 10 years was 73%, 68%, 68% and 45%, respectively. ConclusionsThe use of LT for the treatment of BDI declined over the review period. LT plays a role in selected cases in patients with acute liver failure and ESLD.National survey showing a declining use for liver transplantation in the treatment of bile duct injury but highlighting a key role in selected patients with acute liver failure and end stage liver disease