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03-01-2024 | Liver Transplantation | Original Article

Recipient-associated risk factors for post-liver transplantation biliary complications: A cohort study

Authors: Hamid Reza Mosallaie pour, Gholam Reza Sivandzadeh, Fardad Ejtehadi, Ali Reza Safarpour, Iraj Shahramian, Masoud Tahani, Seyed Alireza Taghavi, Alireza Aminisefat

Published in: Indian Journal of Gastroenterology | Issue 4/2024

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Abstract

Introduction

Biliary complications (BCs) are a well-documented post-liver transplantation concern with potential implications for patient survival. This study aims at identifying risk factors associated with the development of BCs in recipients after liver transplantation (LT) and exploring strategies for their management.

Methods

We conducted a retrospective analysis of 1595 adult patients (age > 18 years) who underwent LT surgery between 2019 and 2021. The study assessed the incidence of BCs in this cohort.

Results

Of 1595 patients, 178 (11.1%) experienced BCs, while 1417 (88.8%) did not exhibit any signs of such complications. Patients who developed BCs were found to have a significantly lower average age (p < 0.001) and longer cold ischemic times (p < 0.001) compared to those without BCs. Variables such as sex, body mass index (BMI), model for end-stage liver disease (MELD) score, primary diagnosis, type of anastomosis, hepatectomy technique, type of transplanted liver and mortality did not demonstrate statistically significant differences between the two groups (p > 0.05). Univariate logistic regression analysis revealed that a cold ischemic time exceeding 12 hours and duct-to-duct anastomosis were positive predictors for BC development (odds ratios of 6.23 [CI 4.29–9.02] and 1.47 [CI 0.94–2.30], respectively). Conversely, increasing age was associated with a protective effect against BC development, with an odds ratio of 0.64 (CI 0.46–0.89).

Conclusion

Our multi-variate analysis identified cold ischemia time (CIT) as the sole significant predictor of post-liver transplantation biliary complications. Additionally, this study observed that advancing patient age had a protective influence in this context. Notably, no significant disparities were detected between hepatectomy techniques and the etiology of liver disease types in the two study groups.

Graphical abstract

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Metadata
Title
Recipient-associated risk factors for post-liver transplantation biliary complications: A cohort study
Authors
Hamid Reza Mosallaie pour
Gholam Reza Sivandzadeh
Fardad Ejtehadi
Ali Reza Safarpour
Iraj Shahramian
Masoud Tahani
Seyed Alireza Taghavi
Alireza Aminisefat
Publication date
03-01-2024
Publisher
Springer India
Published in
Indian Journal of Gastroenterology / Issue 4/2024
Print ISSN: 0254-8860
Electronic ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-023-01479-w

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