Risk Factors for Bile Duct Stenosis in Living Donor Liver Transplantation.

Abstract

[Objectives] In living donor liver transplantation (LDLT), recipients' bile duct is thin and short. And bile duct stenosis was often occurred in LDLT. Furthermore, the patients suffer from bile duct stenosis for a long term. The purpose of this study was to reveal the risk factors for bile duct stenosis in LDLT. [Methods] From 1991 to 2013, we performed 160 cases of LDLT (mean age = 23.5±23.2, left lobe: right lobe = 94:66,). In the present study, we retrospectively investigated the cases and performed univariate and multivariate analyses to identify the independent risk factors for the bile duct stenosis. We defined the bile duct stenosis on the cases which had obstructive jaundice and need to bile duct drainage. [Results] On the univariate analysis, the risk factors identified to be associated with a P < 0.20 were the lumen diameters of the hepatic artery (P = 0.0650), small amounts of gabexate mesilate infusion (anticoagulant therapy) (P = 0.1085), and bile leakage (P = 0.0146). Age, weight, graft lobe, ABO incompatible, acute rejection, the lumen diameters of the bile duct and so on were not the risk factors. Subsequently, we performed a multiple logistic regression analysis of the data and identified bile leakage (P = 0.0186) to be the only independent risk factor for the bile duct stenosis. [Conclusion] On our multivariate analysis study, the only independent risk factor for the bile duct stenosis was bile leakage. It is necessary to reduce bile leakage.