Korean J Intern Med.  2018 Jul;33(4):705-715. 10.3904/kjim.2017.264.

Outcome of donor biliary complications following living donor liver transplantation

Affiliations
  • 1Department of Internal Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 2Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. isle@catholic.ac.kr
  • 3Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 4Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

BACKGROUND/AIMS
Biliary complications are the most common donor complication following living donor liver transplantation (LDLT). The aim of this study is to investigate the long-term outcomes of biliary complications in right lobe adult-to-adult LDLT donors, and to evaluate the efficacy of endoscopic treatment of these donors.
METHODS
The medical charts of right lobe donors who developed biliary complications between June 2000 and January 2008 were retrospectively reviewed.
RESULTS
Of 337 right lobe donors, 49 developed biliary complications, including 36 diagnosed with biliary leakage and 13 with biliary stricture. Multivariate analysis showed that biliary leakage was associated with the number of right lobe bile duct orifices. Sixteen donors, five with leakage and 11 with strictures, underwent endoscopic retrograde cholangiography (ERC). ERC was clinically successful in treating eight of the 11 strictures, one by balloon dilatation and seven by endobiliary stenting. Of the remained three, two were treated by rescue percutaneous biliary drainage and one by conservative care. Of the five patients with leakage, four were successfully treated using endobiliary stents and one with conservative care. In overall, total 35 improved with conservative treatment. All inserted stents were successfully retrieved after a median 264 days (range, 142 to 502) and there were no recurrences of stricture or leakages during a median follow-up of 10.6 years (range, 8 to 15.2).
CONCLUSIONS
All donors with biliary complications were successfully treated non-surgically, with most improving after endoscopic placement of endobiliary stents and none showing recurrence on long term follow-up.

Keyword

Biliary complication; Tissue donors; Cholangiopancreatography, endoscopic retrograde; Liver transplantation
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