27 August 2021 : Original article
Can Microscopic Biliary Reconstruction Reduce Biliary Complication Rate in ABO-Incompatible Adult Living Donor Liver Transplantation?
Yu-Cheng Lin1BCDEF, Tsan-Shiun Lin1ABCDF, Chih-Che Lin1ABCDEF, Yueh-Wei Liu1B, Shih-Ho Wang1B, Yi-Ju Wu1B, Wei-Feng Li1B, Yu-Hung Lin1BCDEF, Ting-Lung Lin1B, Yi-Chia Chan1B, Cheng-Hsi Yeh1B, Chih-Chi Wang1B, Chao-Long Chen1ABDEF, Chee-Chien Yong1ABCDEF*DOI: 10.12659/AOT.931963
Ann Transplant 2021; 26:e931963
Table 5 Univariate analysis of the risk factors for biliary complication in 30 ABO-incompatible patients.
| Biliary complication (n=12) | No-biliary complication (n=18) | p Value | |
|---|---|---|---|
| Age (years) | 53.5±7.59 | 54.2±7.63 | 0.81 |
| Male/Female | 11/1 | 14/4 | 0.32 |
| BMI | 24.5 (21–34) | 26.5 (20–34) | 0.28 |
| Disease | 0.21 | ||
| HBV | 3 (25%) | 12 (66.7%) | |
| HCV | 2 (16.7%) | 2 (11.1%) | |
| PBC | 1 (8.3%) | 0 | |
| Alcoholic | 4 (33.3%) | 3 (16.7%) | |
| Others | 2 (16.7%) | 1 (5.6%) | |
| HCC | 7 (58.3%) | 10 (55.6%) | 0.88 |
| MELD | 11.5 (6–21) | 10.5 (6–20) | 0.71 |
| GRWR (%) | 0.94±0.20% | 0.83±0.20% | 0.15 |
| Graft type | 0.22 | ||
| Right lobe | 6 (50%) | 13 (72.2%) | |
| Left lobe | 6 (50%) | 5 (27.8%) | |
| Biliary reconstruction type | 0.23 | ||
| Duct to duct | 12 (100%) | 16 (88.9%) | |
| Duct to jejunum | 0 | 2 (11.1%) | |
| Warm ischemic time | 45.5 min (30–199) | 37 min (27–71) | 0.71 |
| Cold ischemic time | 41.5 min (25–54) | 42.5 min (27–74) | 1.00 |
| Operation time | 599 min (542–754) | 600 min (431–778) | 1.00 |
| Blood loss | 2675 ml (600–6300) | 2400 ml (300–12000) | 0.71 |
| ABO blood barrier | 0.50 | ||
| Anti-A | 4 (33.3%) | 7 (38.9%) | |
| Anti-B | 3 (25%) | 7 (38.9%) | |
| Anti-A/B | 5 (41.7%) | 4 (22.2%) | |
| Initial IgM | 1:32 (1:4–1:512) | 1:32 (1:8–1:1024) | 1.00 |
| Initial IgG | 1:128 (1:8–1:2048) | 1:128 (1:8–1:2048) | 1.00 |
| Post LT IgM | 1:6 (0–1:16) | 1:4 (1:1–1:128) | 0.71 |
| Post LT IgG | 1:48 (1:1–1:256) | 1:16 (1:2–1:256) | 0.26 |
| IA Rebound (n) | 4 (33.3%) | 4 (22.2%) | 0.44 |
| Initial CD3+ (%) | 63 (22–82) | 66 (43–79) | 1.00 |
| Initial CD19+ (%) | 22 (7–70) | 15 (5–31) | 0.19 |
| ACR within 1 year | 3 (25%) | 4 (22.2%) | 0.86 |
| ABOi – ABO incompatiable; PBC – primary biliary cholangitis; HCC – hepatocellular carcinoma; MELD score – model for end-stage liver disease; GRWR – graft-to-recipient weight ratio; LT – liver transplantation; IA – isoagglutinin; ACR – acute cellular rejection. | |||