Risk factors of biliary complications after liver transplantation: a meta-analysis

Abstract

Objective To determine the risk factors of biliary complications (BC) after liver transplantation (LT),and to provide a theoretical basis to reduce the rate of postoperative biliary complications.Method A meta-analysis was carried out using Revman 5.1.Results Eighteen studies were identified,including 524 patients in the case study group (BC group) and 3967 patients in the control group (Non-BC group).There were no significant differences in donor age,recipient age,primary disease,warm ischemia time,second warm ischemia time,anhepatic phase time and cytomegalovirus infection.The incidence of biliary complications after liver transplantation was significantly different in male than female patients (OR: 1.40; 95％ CI: 1.09～ 1.79;P=0.008).Child C hepatic function increased the incidence of postoperative biliary complications (OR: 1.95; 95％ CI: 1.02 ～3.76;P=0.04).Using a T-tube for biliary reconstruction significantly increased the incidence of postoperative biliary complications (OR: 2.00 ; 95 ％ CI: 1.30～ 3.08 ; P 0.002).The incidence of biliary complications after liver transplantation was significantly different in patients with rejection than those without (OR: 1.80;95％ CI:1.11～2.93;P 0.02).Patients with hepatic artery complications were associated with a higher incidence of postoperative biliary complications (OR: 3.15;95％ CI: 1.37～7.23 ;P=0.007).Patients in the BC group had a significantly longer cold ischemia time and operative time (P＜0.01).Conclusions A male recipient,Child C hepatic function,T-tube drainage,rejection,hepatic artery complications,prolonged cold ischemia time and prolonged operative time were factors affecting the risk of biliary complications.Biliary complications after liver transplantation had no relationship with donor age,recipient age,primary disease,warm ischemia time,second warm ischemia time,anhepatic phase time,and the presence or absence of cytomegalovirus infection. Key words: Liver transplantation; Biliary tract; Postoperative complications; Risk factors ; Meta-analysis