Biliary complications after living and deceased donor liver transplantation

The latest issue of Liver Transplantation reports on the development, management, and resolution of biliary complications after living and deceased donor liver transplantation.

Adult recipients of living donor liver transplantation have a higher incidence of biliary complications than recipients of deceased donor liver transplantation.

Dr Michael Zimmerman and colleagues analyzed the management and resolution of posttransplant biliary complications, and investigated the comparative effectiveness of interventions in living donor liver transplantation and deceased donor liver transplantation recipients. 

Patients participating in this trial were enrolled in the National Institutes of Health–sponsored Adult-to-Adult Living Donor Liver Transplantation Cohort Study and underwent liver transplantation at 8 centers between 1998 and 2006.

The trial was also funded by research grants from Schering-Plough through a cooperative research and development agreement with the National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health, and through a clinical trial agreement between Ortho-Biotech and the National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health.

The research team reported that additional support was provided by the Health Resources and Services Administration and the American Society of Transplant Surgeons.

The numbers, procedure types, and times to resolution were compared for living donor liver transplantation and deceased donor liver transplantation  recipients.

The team of doctors reported that the posttransplant biliary complications occurred in 47 of the 189 deceased donor liver transplantation recipients, and in 141 of the 356 living donor liver transplantation recipients.

Biliary leaks constituted 38% of the post- deceased donor liver transplantation biliary complications

Liver Transplantation

Biliary leaks constituted 38% of the post- deceased donor liver transplantation biliary complications, and 65% of the post-living donor liver transplantation biliary complications.

The median times to first biliary complications were similar for  deceased donor liver transplantation and living donor liver transplantation.

Dr Zimmerman's team commented, "Overall, 1225 diagnostic and therapeutic procedures, including reoperation and retransplantation, were performed."

"The median number of months to the resolution of a biliary complication did not significantly differ between the deceased donor liver transplantation, and living donor liver transplantation groups for leaks or strictures."

"Although the incidence of biliary complications is higher after living donor liver transplantation versus deceased donor liver transplantation, the treatment requirements and the time to resolution after the development of a biliary complication are similar for living donor liver transplantation and deceased donor liver transplantation recipients."