Steatosis of the hepatic graft as a risk factor for post-transplant biliary complications

Umberto Baccarani, Miriam Isola, Gian L. Adani, Claudio Avellini, Dario Lorenzin, Anna Rossetto, Giuseppe Currò, Chiara Comuzzi, Pierluigi Toniutto, Andrea Risaliti, Franca Soldano, Vittorio Bresadola, Dino De Anna, Fabrizio Bresadola

Research output: Contribution to journalArticle

Abstract

Background: Despite recent advances in organ preservation, immunosuppression, and surgical techniques, the biliary tree is still considered the Achilles' heel of liver transplantation. The aim of this study is to retrospectively analyze the incidence of biliary complications and identify risk factors that might predispose to the development of biliary problems.Methods: From January 2004 to December 2007, 117 consecutive liver transplantations were retrospectively analyzed for the development of biliary complications by the review of medical records. Patients were divided into group 1 with biliary complications (n = 43) and group 2 without biliary complications (n = 74).Results: The overall biliary complication rate was 36.8% (leakage 6% and stricture 30.8%). Univariate analysis indicated that significant predictors of biliary complications were the time interval between portal and arterial reperfusion (p = 0.037) and macrovacuolar steatosis of the graft > 25% (p = 0.004). Stepwise logistic regression model demonstrated that a macrosteatosis of the graft > 25% (OR = 5.21 CI 95% [1.79-15.15], p = 0.002) was the only independent risk factor predicting biliary complications after liver transplantation. No differences in patient's and graft's survival were noted between the two groups.Conclusion: According to our experience, transplanting a liver with > 25% of steatosis is a risk factor for the development of biliary complication.

Original languageEnglish
Pages (from-to)631-635
Number of pages5
JournalClinical Transplantation
Volume24
Issue number5
DOIs
Publication statusPublished - Sep 2010

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Liver Transplantation
Transplants
Liver
Logistic Models
Organ Preservation
Biliary Tract
Graft Survival
Immunosuppression
Reperfusion
Medical Records
Pathologic Constriction
Incidence

Keywords

  • Biliary complications
  • Fatty infiltration
  • Liver transplantation
  • Microcirculation
  • Steatosis

ASJC Scopus subject areas

  • Transplantation

Cite this

Baccarani, U., Isola, M., Adani, G. L., Avellini, C., Lorenzin, D., Rossetto, A., ... Bresadola, F. (2010). Steatosis of the hepatic graft as a risk factor for post-transplant biliary complications. Clinical Transplantation, 24(5), 631-635. https://doi.org/10.1111/j.1399-0012.2009.01128.x

Steatosis of the hepatic graft as a risk factor for post-transplant biliary complications. / Baccarani, Umberto; Isola, Miriam; Adani, Gian L.; Avellini, Claudio; Lorenzin, Dario; Rossetto, Anna; Currò, Giuseppe; Comuzzi, Chiara; Toniutto, Pierluigi; Risaliti, Andrea; Soldano, Franca; Bresadola, Vittorio; De Anna, Dino; Bresadola, Fabrizio.

In: Clinical Transplantation, Vol. 24, No. 5, 09.2010, p. 631-635.

Research output: Contribution to journalArticle

Baccarani, U, Isola, M, Adani, GL, Avellini, C, Lorenzin, D, Rossetto, A, Currò, G, Comuzzi, C, Toniutto, P, Risaliti, A, Soldano, F, Bresadola, V, De Anna, D & Bresadola, F 2010, 'Steatosis of the hepatic graft as a risk factor for post-transplant biliary complications', Clinical Transplantation, vol. 24, no. 5, pp. 631-635. https://doi.org/10.1111/j.1399-0012.2009.01128.x
Baccarani, Umberto ; Isola, Miriam ; Adani, Gian L. ; Avellini, Claudio ; Lorenzin, Dario ; Rossetto, Anna ; Currò, Giuseppe ; Comuzzi, Chiara ; Toniutto, Pierluigi ; Risaliti, Andrea ; Soldano, Franca ; Bresadola, Vittorio ; De Anna, Dino ; Bresadola, Fabrizio. / Steatosis of the hepatic graft as a risk factor for post-transplant biliary complications. In: Clinical Transplantation. 2010 ; Vol. 24, No. 5. pp. 631-635.
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abstract = "Background: Despite recent advances in organ preservation, immunosuppression, and surgical techniques, the biliary tree is still considered the Achilles' heel of liver transplantation. The aim of this study is to retrospectively analyze the incidence of biliary complications and identify risk factors that might predispose to the development of biliary problems.Methods: From January 2004 to December 2007, 117 consecutive liver transplantations were retrospectively analyzed for the development of biliary complications by the review of medical records. Patients were divided into group 1 with biliary complications (n = 43) and group 2 without biliary complications (n = 74).Results: The overall biliary complication rate was 36.8{\%} (leakage 6{\%} and stricture 30.8{\%}). Univariate analysis indicated that significant predictors of biliary complications were the time interval between portal and arterial reperfusion (p = 0.037) and macrovacuolar steatosis of the graft > 25{\%} (p = 0.004). Stepwise logistic regression model demonstrated that a macrosteatosis of the graft > 25{\%} (OR = 5.21 CI 95{\%} [1.79-15.15], p = 0.002) was the only independent risk factor predicting biliary complications after liver transplantation. No differences in patient's and graft's survival were noted between the two groups.Conclusion: According to our experience, transplanting a liver with > 25{\%} of steatosis is a risk factor for the development of biliary complication.",
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AU - Isola, Miriam

AU - Adani, Gian L.

AU - Avellini, Claudio

AU - Lorenzin, Dario

AU - Rossetto, Anna

AU - Currò, Giuseppe

AU - Comuzzi, Chiara

AU - Toniutto, Pierluigi

AU - Risaliti, Andrea

AU - Soldano, Franca

AU - Bresadola, Vittorio

AU - De Anna, Dino

AU - Bresadola, Fabrizio

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