Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 27, 2021; 13(12): 2081-2103
Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.2081
Biliary complications in recipients of living donor liver transplantation: A single-centre study
Reginia Nabil Guirguis, Ehab Hasan Nashaat, Azza Emam Yassin, Wesam Ahmed Ibrahim, Shereen A Saleh, Mohamed Bahaa, Mahmoud El-Meteini, Mohamed Fathy, Hany Mansour Dabbous, Iman Fawzy Montasser, Manar Salah, Ghada Abdelrahman Mohamed
Reginia Nabil Guirguis, Ehab Hasan Nashaat, Azza Emam Yassin, Wesam Ahmed Ibrahim, Shereen A Saleh, Ghada Abdelrahman Mohamed, Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt
Mohamed Bahaa, Mahmoud El-Meteini, Mohamed Fathy, Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt
Hany Mansour Dabbous, Iman Fawzy Montasser, Manar Salah, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt
Author contributions: Guirguis RN, Nashaat EH, Yassin AE, Ibrahim WA, Saleh SA, Bahaa MM designed the research; Bahaa MM, El-Meteini M, Fathy M performed the surgical procedures; Guirguis RN, Dabbous HM, Montasser IF, Salah M performed the perioperative management; Guirguis RN participated in the acquisition of data; Guirguis RN, Nashaat EH, Yassin AE, Ibrahim WA, Saleh SA, Mohamed GA participated in the analysis and interpretation of the data; Guirguis RN, Saleh SA, Bahaa MM, Mohamed GA revised the article critically for important intellectual content; Mohamed GA wrote the manuscript.
Institutional review board statement: The study was reviewed and approved by the institutional review board of Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Informed consent statement: Informed consent statement was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All authors have nothing to disclose.
Data sharing statement: The statistical code and dataset are available from the corresponding author at ghadaabdelrahman@med.asu.edu.eg
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ghada Abdelrahman Mohamed, MD, Lecturer, Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, El-Khalifa El-Maamon Street, Abbassia, Cairo 11591, Egypt. ghadaabdelrahman@med.asu.edu.eg
Received: March 9, 2021
Peer-review started: March 9, 2021
First decision: May 2, 2021
Revised: May 2, 2021
Accepted: October 24, 2021
Article in press: October 24, 2021
Published online: December 27, 2021
Processing time: 292 Days and 10 Hours
ARTICLE HIGHLIGHTS
Research background

Despite considerable progress in liver transplantation (LT) surgical performance and peri-operative management, post-LT biliary complications (BCs) remain a considerable cause of morbidity, mortality, increased cost, and graft loss.

Research motivation

Many studies have focused on biliary complications to improve care for transplanted recipients; however, data on long-term outcomes remain scarce.

Research objectives

We aimed to investigate the impact of BCs after right lobe-LDLT (RL-LDLT) on chronic graft rejection, graft failure and mortality.

Research methods

From 2011 to 2016, 215 adult recipients underwent RL-LDLT at our centre. We excluded 46 recipients who met the exclusion criteria, and 169 recipients were included in the final analysis. Donors’ and recipients’ demographic data, clinical data, operative details and postoperative course information were collected. We also reviewed the management and outcomes of BCs. Recipients were followed for at least 12 mo post-LT until December 2017 or graft or patient loss.

Research results

The overall incidence rate of BCs including biliary leakage, biliary infection and biliary stricture was 57.4%. Twenty-seven (16%) patients experienced chronic graft rejection. Graft failure developed in 20 (11.8%) patients. A total of 28 (16.6%) deaths occurred during follow-up. BCs were a risk factor for the occurrence of chronic graft rejection and failure; however, mortality was determined by recurrent hepatitis C virus infection.

Research conclusions

Biliary complications after RT-LDLT represent an independent risk factor for chronic graft rejection and graft failure; nonetheless, effective management of these complications can improve patient and graft survival.

Research perspectives

Multi-centre large-scale studies are required to comprehensively investigate the risk factors for the occurrence and impacts of BC.