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Article
Biliary complications after pediatric liver transplantation revisited
Transplantation proceedings
  • Thomas Heffron
  • Todd Pillen
  • Gregory Smallwood, Philadelphia College of Osteopathic Medicine
  • D. Redd
  • Rene Romero
Document Type
Article
Publication Date
1-1-2003
Abstract
Background. Biliary complications in pediatric liver transplantation (PLT) are associated with increased morbidity and mortality. Methods. Prospectively, data was collected on 89 consecutive liver transplants performed in 82 children. Eighty-nine consecutive PLTs were tracked for transplant type (partial versus whole), recipient age/weight, duct anastomosis type, surgical technique, and biliary complications. Treatments of biliary complications (surgical versus interventional radiology) were also evaluated. Results. Forty-six children (51.7%) received partial transplants and 43 (48.3%) children received whole organs. The average age for whole liver transplanted children was 8.95 ± 6.62 years and average weight was 36.2 ± 28.7 kg; for those receiving partial livers, 3.19 ± 3.52 years and 14.1 ± 13.0 kg. Duct-to-duct anastomosis was performed for 26 grafts and Roux-en-Y choledochojejunostomy for 63 grafts. Biliary complications occurred in 10 of 89 (11.2%) grafts. Complications included anastomotic strictures in four (40%), bile leak in five (50%), intraparenchymal biloma in one (10%). The complication rate for whole organs was 1/43 (2.3%) and 9/46 (19.6%) for partial organ (P =. 015). No difference in complication rates were seen in type of ductal anastomosis (7.7% vs 12.7%, P = NS). Reoperation for biliary complication was necessary in only 2/10 (20%) of grafts. Conclusion. Technical advances have reduced the incidence of biliary complications in PLT. Partial liver grafts have a statistically higher risk of biliary complication than whole grafts. Most biliary complications can be managed with radiological intervention without surgical exploration. Pediatric biliary complications are not associated with graft loss.
Comments

This article was published in Transplantation proceedings, Volume 35, Issue 4, Pages 1461-1462.

The published version is available at http://dx.doi.org/10.1016/S0041-1345(03)00463-9.

Copyright © 2003 Elsevier.

Citation Information
Thomas Heffron, Todd Pillen, Gregory Smallwood, D. Redd, et al.. "Biliary complications after pediatric liver transplantation revisited" Transplantation proceedings Vol. 35 Iss. 4 (2003) p. 1461 - 1462
Available at: http://works.bepress.com/gregory_smallwood/34/