Biliary strictures complicating living donor liver transplantation: Problems, novel insights and solutions

Table 1 Incidence of biliary strictures with median time of onset after living donor liver transplantation

Study	Year	Total number, n	Biliary strictures, %	Median time of onset after LT in mo
Yazumi et al[13]	2006	273	27	6.2
Seo et al[43]	2009	239	12	8.6
Chang et al[22]	2010	353	32	-
Hsieh et al[11]	2013	110	37	2.1
Wadhawan et al[93]	2013	338	10	3
Ranjan et al[94]	2016	305	3	12
Rao et al[31]	2017	458	10	-

LT: Liver transplantation.

Table 2 Therapeutic efficacy and factors affecting outcome of endotherapy in biliary strictures complicating living donor liver transplantation

Study	Year	Biliary strictures, n (%)	Median duration of stent therapy	Overall stricture resolution, %	Factors that affected endoscopic outcome
Zoepf et al[68]	2005	7 (7.78)	4 mo	100
Yazumi et al[13]	2006	75 (27.5)	8.9 mo	33
Gomez et al[30]	2009	10 (33.34)		20
Seo et al[43]	2009	29 (12.1)	24.1 ± 12.7 wk	65
Chang et al[22]	2010	113 (32)		48	NAS, HAT, Pretransplant TACE
Hsieh et al[11]	2013	41 (37.3)	5.3 mo	79
Wadhawan et al[93]	2013	35 (10.4)		91
Ranjan et al[94]	2016	10 (3.28)	4 mo	70
Rao et al[31]	2017	41 (10.2)	6 mo	48	Donor age, multiple biliary anastomoses, duration of stent therapy
Kato et al[9]	2009	41 (42.7)	14.5 mo	85	Stricture length, bile leak

HAT: Hepatic artery thrombosis; NAS: Nonanastomotic strictures; TACE: Transarterial chemoembolization.

Table 3 Role of self-expanding metal stent in the management of post living donor liver transplantation biliary strictures

Study	Year	Patients who underwent cSEMS, n	Duration of stent therapy	Stricture resolution, %	Complications, %
Kaffes et al[87]	2014	10	12 wk	100	10
Jang et al[89]	2017	35	3.2 ± 1.4 mo	82.9	14.3
Kao et al[88]1	2013	200	3 mo	80-95	16
Rao et al2	2018	4	8 mo		75

¹This was a meta-analysis comparing SEMS with multiple plastic stent, and both DDLT and LDLT patients were included;

²Unpublished data. cSEMS: Covered Self-expanding metal stent; DDLT: Dead donor liver transplantation; SEMS: Self-expanding metal stent.