Differences in Risk Factors for Early-onset and Late-onset Biliary Complications in Liver Transplant Patients

Hsiu-Lung Fan ； An-Chieh Feng ； Meng-Hsing Ho ； Shih-Ming Kuo ； Wei-Chou Chang ； Teng-Wei Chen

《Journal of Medical Sciences》 35卷5期 (2015/10) Pp. 201-207

https://doi.org/10.4103/1011-4564.167743

並列摘要

Context: Despite the use of advanced surgical techniques, the incidence of biliary complications (BCs) after liver transplantation (LT) is high. Hence, there may be additional unidentified causes of BC. Aims: To identify the risk factors for BCs occurring within 6 months or beyond 6 months after LT. Materials and Methods: We enrolled 237 patients who underwent LT from August 2001 to December 2012. Of the 237 patients, 173 did not have BCs (no BC group), 42 had BCs within 6 months after LT (early-onset BC group), and 22 had BCs beyond 6 months after LT (late-onset BC group). Statistical Analysis Used: Patients' demographic, clinical, and biochemical data were analyzed using the Mann-Whitney U-test, Chi-square test, Fisher's exact test, and multiple logistic regression analysis. Results: Multivariate analysis indicated that only partial liver graft (odds ratio [OR], 2.741; 95% confidence interval [CI], 1.236-6.077; P=0.013) was an independent risk factor for early-onset BC after LT, whereas acute rejection (OR, 6.556; 95% CI, 2.380-18.056; P ＜ 0.001), multiple bile ducts (OR, 4.227; 95% CI, 1.212-14.740; P=0.024), and pre-LT serum albumin level (OR, 2.234; 95% CI, 1.178-4.238; P=0.014) were the independent risk factors for late-onset BC after LT. Conclusion: Early-onset and late-onset BCs after LT are associated with different risk factors. Partial liver graft is a risk factor for early-onset BC, whereas pre-LT serum albumin level, multiple bile ducts, and acute rejection are the risk factors for late-onset BC. As it is easily controllable, prevention of acute rejection may help to reduce the incidence of BCs.

並列關鍵字

Acute rejection ； biliary complication ； liver transplantation