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Biliary Complication in Pediatric Liver Transplantation: a Single-Center 15-Year Experience

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The incidence and several risk factors of biliary complication (BC) following pediatric liver transplantation (LT) are widely known, but data on long-term outcomes and management is limited. This retrospective study aimed to investigate the incidence, associated risk factors, management, and outcomes of early and late BC in pediatric LT.

Methods

This study enrolled 134 pediatric patients (< 18 years old) who underwent LT at a tertiary care center in Taiwan between January 2001 and December 2015. Diagnosis of BC was based on clinical, biochemical, and radiologic examinations. Clinical data and chart records were reviewed and compared between the groups.

Results

Among the 134 children, 21 children (15.7%) had BC after LT. Nine children had early complications, including leakage plus stricture (n = 2), stricture only (n = 2), and leakage only (n = 5). Twelve children had late BC; all of whom had anastomotic stricture. Of the 21 patients with BC, 11 patients (52.4%) were treated without surgery. The median time of first treatment for BC was 6.5 months (range, 11 days to 6.2 years). Five of the 9 patients with early complications and two of the 12 patients with late complications died of biliary tract infection. The major risk factors of BC in pediatric LT were (1) recipient age > 2 years, (2) Kasai portoenterostomy revision, and (3) hepatic artery thrombosis.

Conclusions

Several risk factors of BC in pediatric LT were identified. Children with early BC appeared to have relatively unfavorable outcomes. However, late BC treated by either radiological or surgical methods appeared to have a relatively good long-term prognosis.

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Authors and Affiliations

  1. Department of Surgery, National Taiwan University Hospital Yun-Lin Branch, Douliou City of Yun-Lin County, Taiwan

    Chih-Yang Hsiao

  2. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Chih-Yang Hsiao

  3. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan

    Cheng-Maw Ho, Yao-Ming Wu, Ming-Chih Ho, Rey-Heng Hu & Po-Huang Lee

  4. College of Medicine, National Taiwan University, Taipei, Taiwan

    Yao-Ming Wu, Ming-Chih Ho, Rey-Heng Hu & Po-Huang Lee

  5. Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan

    Ming-Chih Ho

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Contributions

Hsiao CY and Ho MC contributed to data collection, interpretation of data, and drafted the manuscript; Ho MC and Hu RH contributed to study concept and design; Hsiao CY, Ho CM, Wu YM, Ho MC, Hu RH, and Lee PH contributed to critical revision of the manuscript.

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Correspondence to Ming-Chih Ho.

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Hsiao, CY., Ho, CM., Wu, YM. et al. Biliary Complication in Pediatric Liver Transplantation: a Single-Center 15-Year Experience. J Gastrointest Surg 23, 751–759 (2019). https://doi.org/10.1007/s11605-018-04076-x

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  • DOI: https://doi.org/10.1007/s11605-018-04076-x

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