Incidence and Risk Factors of Biliary Tract Complications after Liver Transplantation at Siriraj Hospital
Prawej Mahawithitwong MD*, Warapan Numprasit MD*, Yongyut Sirivatanauksorn MD PhD*, Somchai Limsrichamrern MD*, Prawat Kositamongkol MD*, Supreecha Asavakarn MD*, Chutwichai Tovikkai MD PhD*, Wethit Dumronggittigule MD*
Affiliation : * Hepato-pancreatobiliary and Transplant Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Biliary tract complications remain one of the major problems after orthotopic liver transplantation (OLT), causing
several consequent morbidities and mortalities. Therefore, the incidence and risk factors of these complications were studied
to identify preventable causes and improve the outcomes.
Material and Method: Adult cadaveric-donor OLT patients at Siriraj Hospital between January 2002 and July 2014 were
retrospectively reviewed. The patients who developed biliary complications were analyzed. Clinical factors and outcomes of
treatment modalities were evaluated.
Results : A total of 195 patients underwent OLT, 16 patients had biliary complications after OLT. The overall incidence of
biliary complications was 8.2%, including bile leakage rate of 2.1% and anastomotic stricture rate of 7.2%. Intra-operative
blood transfusion (p = 0.04), platelet transfusion (p = 0.04) and fresh frozen plasma transfusion (p = 0.02) are the risk
factors associated with biliary tract complications. Nevertheless, no independent risk factor was identified by the multivariate
analysis.
Conclusion : Biliary tract complications after OLT cause significant morbidities to the patients. Intra-operative blood and its
components such as platelet and fresh frozen plasma transfusion were the risk factors for biliary tract complications after
OLT.
Keywords : Biliary, Complication, Deceased donor, Liver transplantation
