Research For Risk Factors Of Biliary Complications After Liver Transplantation Of DCD

BackgroundBiliary complications are the most common source of morbidity after DCD liver transplantation, affecting the success rate and postoperative quality of life. We retrospectively analysed the risk factors contributing to the development of biliary complication to investigate and estimate the clinical features and risk factors associated with biliary complication.Method109cases of DCD liver transplantation admitted in the1st affiliated of Zhejiang University from October2010to October2013were studied retrospectively, the characteristics of donors includes age、sex、height、weight、BMI(body mass index), cause of death (trauma, cerebrovascular accident, anoxia and other), serum levels (ALT/AST7TB/ALB/PT), ABO blood types, hepatitis B surface antigen, use of inotropic agents (dobutamine/dopamine); days of ICU treatment, warm ischemia time, cold ischemia Time, fatty liver. Result24(22%) recipients were developed biliary complication, including16anastomotic stoma stenosis,5non-anastomotic biliary stricture,1leakage and2stones. By menas of univariate analysis, risk factors associated with biliary complication were warm ischemia time (P<0.001), days of ICU treatment (P=0.013). There were no significant difference in ABO blood types.Use of inotropic agents and fatty liver can increase the trend of biliary complication. Multiple-factor analysis demonstrated that warm ischemia time, days of ICU treatment were independent risk factors predicting biliary complication. When warm ischemia time is more than9minutes, it increases biliary complications.ConclusionBiliary complication remains a major problem post DCD hepatic transplantation. Warm ischemia time and days of ICU treatment were independent risk factors predicting biliary complication. When warm ischemia time is more than9minutes, it increases biliary complication.Reduce the use of inotropic agents and fatty liver can help decreasing the biliary complications. Cause of death and ABO blood types are uncorrelated with biliary complication.