Impact of biliary complications on quality of life in live-donor liver transplant recipients

Table 1 Descriptive categorical data for live-donor liver transplant recipients with biliary complications

Variable		n (%)
Indication of liver transplantation	HCV	21 (84)
	HBV	1 (4)
	Combined HCV and HBV	1 (4)
	Hepatocellular carcinoma	2 (8)
Donors’ gender	Male	17 (68)
	Female	8 (32)
Recipients’ gender	Male	19 (76)
	Female	6 (24)
Immunosuppressant	Tacrolimus	22 (88)
	Cyclosporine	3 (12)
Biliary leakage	-	7 (28)
	+	18 (72)
Need of pigtail catheter for biloma (total = 18)	-	15 (83.3)
	+	3 (16.6)
Biliary infection	-	0 (0)
	+	25 (100)
Frequency of biliary infection (total = 25)	1-2 Episodes	16 (64)
	≥ 3 Episodes	9 (36)
Biliary stricture	-	5 (20)
	+	20 (80)
Frequency of biliary stricture (total = 20)	1-2 Episodes	13 (65)
	≥ 3 Episodes	7 (28)
Need for ERCP	-	5 (20)
	+	20 (80)
Frequency of ERCP	1-2 ERCP	13 (65)
	≥ 3 ERCP	7 (28)
Need for PTC	-	22 (88)
	+	3 (12)
Frequency of PTC	1 PTC	2 (66.6)
	2 PTC	1 (33.3)
Surgical intervention for stricture	-	19 (95)
	+	1 (5)
Admission related to biliary complications	-	0 (0)
	+	25 (100)
Early biliary infection (total = 25)	-	2 (8)
	+	23 (92)
Early biliary stricture (total = 20)	-	17 (68)
	+	8 (32)

Data presented in number (n) and percentage (%). ERCP: Endoscopic retrograde cholangiopancreatography; HBV: Hepatitis B virus; HCV: Hepatitis C virus; PTC: Percutaneous transhepatic cholangiography.

Table 2 Descriptive numerical data for live-donor liver transplant recipients with biliary complications

Variable	Data
MELD score	15 ± 3
Child score	9 ± 2
Donors’ age (yr)	30 ± 4
Donors’ BMI (kg/m2)	25 ± 4
Recipient's age (yr)	52 ± 7
Recipient's BMI (kg/m2)	27 ± 6
Total bilirubin (mg/dL)	2.9 (2-3.9)
Direct bilirubin (mg/dL)	1.6 (0.9-2.3)
Alkaline phosphatase (IU/L)	190 ± 49
Gamma-glutamyl transferase (IU/L)	100 (50-130)
Platelets (109/L)	75 ± 31
Cold ischemia time (min)	48 ± 25
Warm ischemia time (min)	47 ± 23
Graft arterialization time (min)	145 ± 53
Time to biliary infection (d)	13 (11-36)
Time to biliary stricture (d)	130 (120-190)

Data are presented as mean ± SD or median and range. BMI: Body mass index; MELD: Model for end stage liver disease.

Table 3 Comparison of the quality-of-life scores for live-donor liver transplant recipients with biliary complications and their corresponding norm-based scores

HRQoL score	LDLT-R with BC	NBS score	P value1
Physical functioning	50 (50-75)	41.3 (41.3-49.2)	0.003
Role physical	50 (31.3-75)	40.5 (34.2-49)	0.001
Bodily pain	50 (50-75)	39.7 (39.7-48.7)	0.003
General health	60 (60-85)	47.8 (47.8-57.7)	0.004
Vitality	50 (25-50)	49.1 (39.2-49.1)	1.000
Social functioning	50 (50-50)	39.1 (39.1-39.1)	0.005
Role emotion	50 (37.5-75)	35.5 (30.3-45.9)	< 0.001
Mental health	50 (50-62.5)	41.3 (41.3-47)	0.001

¹Wilcoxon signed ranks test.

Data are shown as median and interquartile range. BC: Biliary complications; HRQoL: Health related quality of life; LDLT-R: Live donor liver transplant recipients; NBS: Norm based score.

Table 4 Comparison of health-related quality-of-life scores between patients and controls

HRQoL domain	Patients (n = 25)	Controls (n = 25)	P value1
Physical functioning	50 (50-75)	100 (100-100)	< 0.001
Role physical	50 (31.3-75)	100 (87.5-100)	< 0.001
Bodily pain	50 (50-75)	100 (100-100)	< 0.001
General health	60 (60-85)	85 (85-85)	< 0.001
Vitality	50 (25-50)	75 (75-87.5)	< 0.001
Social functioning	50 (50-50)	75 (75-100)	< 0.001
Role emotion	50.0 (37.5-75)	87.5 (75-100)	< 0.001
Mental health	50 (50-62.5)	87.5 (75-87.5)	< 0.001
PCS	44.8 (41.7-52.9)	57.8 (55.2-59)	< 0.001
MCS	42 (35.6-45.2)	52.9 (50.2-57.9)	< 0.001

¹Wilcoxon signed ranks test.

Data are shown as median and interquartile range; Patients: Live donor liver transplant recipients with biliary complications; Controls: Live donor liver transplant recipients without biliary complications; HRQoL: Health-related quality-of-life; MCS: Mental component summary score; PCS: Physical component summary score.

Table 5 Physical and mental component summary scores in patients and controls compared with norm-based scores

Variable	NBS	Patients (n = 25), %	Control (n = 25) , %	P value1
Physical component summary score	At or above	11 (44)	25 (100)	0.0002
	Below	8 (32)	0 (0)
	Far below	6 (24)	0 (0)
Mental component summary score	At or above	7 (28)	24 (96)	< 0.0001
	Below	7 (28)	1 (4)
	Far below	11 (44)	0 (0)

¹Chi-squared test for trend.

Data are shown as number and percentage. Patients: Live donor liver transplant recipients with biliary complications; Controls: Live donor liver transplant recipients without biliary complications; NBS: Norm based score.