The Korean journal of internal medicine

  • 제33권4호
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  • Pages.705-715
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  • 2018
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Outcome of donor biliary complications following living donor liver transplantation

  • Woo, Hyun Young (Department of Internal Medicine and Medical Research Institute, Pusan National University Hospital) ;
  • Lee, In Seok (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Chang, Jae Hyuck (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Youn, Seung Bae (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Bae, Si Hyun (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Choi, Jong Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Chun, Ho Jong (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • You, Young Kyoung (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dong Goo (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Yoon, Seung Kew (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • 투고 : 2017.07.27
  • 심사 : 2017.11.10
  • 발행 : 2018.07.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Biliary complications are the most common donor complication following living donor liver transplantation (LDLT). The aim of this study is to investigate the long-term outcomes of biliary complications in right lobe adult-to-adult LDLT donors, and to evaluate the efficacy of endoscopic treatment of these donors. Methods: The medical charts of right lobe donors who developed biliary complications between June 2000 and January 2008 were retrospectively reviewed. Results: Of 337 right lobe donors, 49 developed biliary complications, including 36 diagnosed with biliary leakage and 13 with biliary stricture. Multivariate analysis showed that biliary leakage was associated with the number of right lobe bile duct orifices. Sixteen donors, five with leakage and 11 with strictures, underwent endoscopic retrograde cholangiography (ERC). ERC was clinically successful in treating eight of the 11 strictures, one by balloon dilatation and seven by endobiliary stenting. Of the remained three, two were treated by rescue percutaneous biliary drainage and one by conservative care. Of the five patients with leakage, four were successfully treated using endobiliary stents and one with conservative care. In overall, total 35 improved with conservative treatment. All inserted stents were successfully retrieved after a median 264 days (range, 142 to 502) and there were no recurrences of stricture or leakages during a median follow-up of 10.6 years (range, 8 to 15.2). Conclusions: All donors with biliary complications were successfully treated non-surgically, with most improving after endoscopic placement of endobiliary stents and none showing recurrence on long term follow-up.

키워드

과제정보

연구 과제 주관 기관 : National Research Foundation of Korea (NRF), Pusan National University Hospital

참고문헌

  1. Yamaoka Y, Washida M, Honda K, et al. Liver transplantation using a right lobe graft from a living related donor. Transplantation 1994;57:1127-1130. https://doi.org/10.1097/00007890-199404150-00024
  2. Tanaka K, Yamada T. Living donor liver transplantation in Japan and Kyoto University: what can we learn? J Hepatol 2005;42:25-28.
  3. Lo CM. Complications and long-term outcome of living liver donors: a survey of 1,508 cases in five Asian centers. Transplantation 2003;75(3 Suppl):S12-S15. https://doi.org/10.1097/01.TP.0000046534.45645.47
  4. Trotter JF, Wachs M, Everson GT, Kam I. Adult-to-adult transplantation of the right hepatic lobe from a living donor. N Engl J Med 2002;346:1074-1082. https://doi.org/10.1056/NEJMra011629
  5. Trotter JF. Living donor liver transplantation: is the hype over? J Hepatol 2005;42:20-25.
  6. Shiffman ML, Brown RS Jr, Olthoff KM, et al. Living donor liver transplantation: summary of a conference at The National Institutes of Health. Liver Transpl 2002;8:174-188. https://doi.org/10.1053/jlts.2002.30981
  7. Brown RS Jr, Russo MW, Lai M, et al. A survey of liver transplantation from living adult donors in the United States. N Engl J Med 2003;348:818-825. https://doi.org/10.1056/NEJMsa021345
  8. Humar A. Donor and recipient outcomes after adult living donor liver transplantation. Liver Transpl 2003;9(10 Suppl 2):S42-S44.
  9. Ghobrial RM, Freise CE, Trotter JF, et al. Donor morbidity after living donation for liver transplantation. Gastroenterology 2008;135:468-476. https://doi.org/10.1053/j.gastro.2008.04.018
  10. Shio S, Yazumi S, Ogawa K, et al. Biliary complications in donors for living donor liver transplantation. Am J Gastroenterol 2008;103:1393-1398. https://doi.org/10.1111/j.1572-0241.2008.01786.x
  11. Gruttadauria S, Marsh JW, Vizzini GB, et al. Analysis of surgical and perioperative complications in seventy-five right hepatectomies for living donor liver transplantation. World J Gastroenterol 2008;14:3159-3164. https://doi.org/10.3748/wjg.14.3159
  12. Hasegawa K, Yazumi S, Egawa H, et al. Endoscopic management of postoperative biliary complications in donors for living donor liver transplantation. Clin Gastroenterol Hepatol 2003;1:183-188. https://doi.org/10.1016/S1542-3565(03)70034-2
  13. Fujita S, Kim ID, Uryuhara K, et al. Hepatic grafts from live donors: donor morbidity for 470 cases of live donation. Transpl Int 2000;13:333-339. https://doi.org/10.1111/j.1432-2277.2000.tb02053.x
  14. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
  15. Lauterio A, Di Sandro S, Gruttadauria S, et al. Donor safety in living donor liver donation: an Italian multicenter survey. Liver Transpl 2017;23:184-193. https://doi.org/10.1002/lt.24651
  16. Lee JG, Lee KW, Kwon CHD, et al. Donor safety in living donor liver transplantation: the Korean organ transplantation registry study. Liver Transpl 2017;23:999-1006. https://doi.org/10.1002/lt.24778
  17. Beavers KL, Sandler RS, Shrestha R. Donor morbidity associated with right lobectomy for living donor liver transplantation to adult recipients: a systematic review. Liver Transpl 2002;8:110-117. https://doi.org/10.1053/jlts.2002.31315
  18. Iida T, Ogura Y, Oike F, et al. Surgery-related morbidity in living donors for liver transplantation. Transplantation 2010;89:1276-1282. https://doi.org/10.1097/TP.0b013e3181d66c55
  19. Abecassis MM, Fisher RA, Olthoff KM, et al. Complications of living donor hepatic lobectomy: a comprehensive report. Am J Transplant 2012;12:1208-1217. https://doi.org/10.1111/j.1600-6143.2011.03972.x
  20. Uchiyama H, Shirabe K, Nakagawara H, et al. Revisiting the safety of living liver donors by reassessing 441 donor hepatectomies: is a larger hepatectomy complication-prone? Am J Transplant 2014;14:367-374. https://doi.org/10.1111/ajt.12559
  21. Yuan Y, Gotoh M. Biliary complications in living liver donors. Surg Today 2010;40:411-417. https://doi.org/10.1007/s00595-009-4143-1
  22. Yazumi S, Chiba T. Biliary complications after a rightlobe living donor liver transplantation. J Gastroenterol 2005;40:861-865. https://doi.org/10.1007/s00535-005-1698-5
  23. Taketomi A, Kayashima H, Soejima Y, et al. Donor risk in adult-to-adult living donor liver transplantation: impact of left lobe graft. Transplantation 2009;87:445-450. https://doi.org/10.1097/TP.0b013e3181943d46
  24. Kasahara M, Egawa H, Takada Y, et al. Biliary reconstruction in right lobe living-donor liver transplantation: comparison of different techniques in 321 recipients. Ann Surg 2006;243:559-566. https://doi.org/10.1097/01.sla.0000206419.65678.2e
  25. Agarwal N, Sharma BC, Garg S, Kumar R, Sarin SK. Endoscopic management of postoperative bile leaks. Hepatobiliary Pancreat Dis Int 2006;5:273-277.
  26. Ostroff JW. Post-transplant biliary problems. Gastrointest Endosc Clin N Am 2001;11:163-183. https://doi.org/10.1016/S1052-5157(18)30092-8
  27. Verdonk RC, Buis CI, Porte RJ, et al. Anastomotic biliary strictures after liver transplantation: causes and consequences. Liver Transpl 2006;12:726-735. https://doi.org/10.1002/lt.20714
  28. Hwang S, Lee SG, Sung KB, et al. Long-term incidence, risk factors, and management of biliary complications after adult living donor liver transplantation. Liver Transpl 2006;12:831-838. https://doi.org/10.1002/lt.20693
  29. Amesur NB, Zajko AB. Interventional radiology in liver transplantation. Liver Transpl 2006;12:330-351. https://doi.org/10.1002/lt.20731
  30. Chang JM, Lee JM, Suh KS, et al. Biliary complications in living donor liver transplantation: imaging findings and the roles of interventional procedures. Cardiovasc Intervent Radiol 2005;28:756-767. https://doi.org/10.1007/s00270-004-0262-7

피인용 문헌

  1. Endoscopic management of biliary strictures post-liver transplantation vol.7, pp.4, 2018, https://doi.org/10.13105/wjma.v7.i4.120
  2. Health-Related Quality of Life in Predominantly Young Parental Living Liver Donors: A Cross-Sectional Study in China vol.8, pp.None, 2018, https://doi.org/10.3389/fmed.2021.726103
  3. Clinical usefulness of T1-weighted MR cholangiography with Gd-EOB-DTPA for the evaluation of biliary complication after liver transplantation vol.25, pp.1, 2018, https://doi.org/10.14701/ahbps.2021.25.1.39