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Arterial and biliary complications after living donor liver transplantation: a single-center retrospective study and literature review

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Abstract

Aim

The mortality of patients on the waiting list for deceased donor liver transplantation (DDLT) is high, especially in countries where donation rates are low. Thus, living donor liver transplantation (LDLT) is an attractive option. However, compared with DDLT, LDLT is associated with increased rates of arterial and biliary complications. We examined the rates of complications and risk factors following LDLT.

Methods

We retrospectively investigated and compared the rates of complications of DDLT and LDLT in our institute. We also performed univariate and multivariate analyses to identify the independent risk factors for these complications. The complications and specific disadvantages of LDLT were reviewed and discussed.

Results

The incidence rate of arterial complications in LDLT was 6.0%, compared with 3.2% (13/441) in DDLT. A multivariate analysis identified low body weight (P = 0.032) as the only independent risk factor for hepatic artery thrombosis. The rate of all biliary complications in LDLT was 17.3%, compared with 18.7% in DDLT. The risk factors for biliary stricture identified by the multivariate analysis were recurrent cholangitis and the number of bile ducts. The durations of hospital stay and overall survival rates were similar between the two groups.

Conclusion

Given the shortage of deceased donor organs, we believe that LDLT is acceptable in an attempt to meet demand.

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Acknowledgements

This study was supported by the Grants-in-Aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan and the Ministry of Welfare of Japan, and a Grant from Tohoku University Graduate School of Medicine.

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Authors and Affiliations

  1. Division of Transplantation, Reconstruction, and Endoscopic Surgery, Department of Surgery, Upper Digestive and Vascular Surgery, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan

    Shigehito Miyagi, Yuta Kakizaki, Kenji Shimizu, Koji Miyazawa, Wataru Nakanishi, Yasuyuki Hara, Kazuaki Tokodai, Chikashi Nakanishi, Takashi Kamei, Noriaki Ohuchi & Susumu Satomi

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  1. Shigehito Miyagi
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  2. Yuta Kakizaki
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  3. Kenji Shimizu
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  4. Koji Miyazawa
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  5. Wataru Nakanishi
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  6. Yasuyuki Hara
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  10. Noriaki Ohuchi
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  11. Susumu Satomi
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Correspondence to Shigehito Miyagi.

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Miyagi, S., Kakizaki, Y., Shimizu, K. et al. Arterial and biliary complications after living donor liver transplantation: a single-center retrospective study and literature review. Surg Today 48, 131–139 (2018). https://doi.org/10.1007/s00595-017-1515-9

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  • DOI: https://doi.org/10.1007/s00595-017-1515-9

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