Liver Transplantation Across Rh Blood Group Barriers Increases the Risk of Biliary Complications |
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Authors: | Juli Busquets Jose Castellote Jaume Torras Juan Fabregat Emilio Ramos Laura Llado Antonio Rafecas Esmeralda de la Banda Juan Figueras |
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Affiliation: | (1) Department of Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain;(2) Department of Gastroenterology, Hospital Universitari de Bellvitge, Barcelona, Spain;(3) Department of Haematology, Hospital Universitari de Bellvitge, Barcelona, Spain;(4) Department of Surgery, Hospital Josep Trueta, Girona, Spain;(5) Hospital Universitari de Bellvitge, c/ Feixa Llarga s.n., 08907 Barcelona, Spain |
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Abstract: | Background Cold ischemia time and the presence of postoperative hepatic arterial thrombosis have been associated with biliary complications (BC) after liver transplantation. An ABO-incompatible blood group has also been suggested as a factor for predisposal towards BC. However, the influence of Rh nonidentity has not been studied previously. Materials Three hundred fifty six liver transplants were performed from 1995 to 2000 at our hospital. BC incidence and risk factors were studied in 345 patients. Results Seventy patients (20%) presented BC after liver transplantation. Bile leakage (24/45%) and stenotic anastomosis (21/30%) were the most frequent complications. Presence of BC in Rh-nonidentical graft–host cases (23/76, 30%) was higher than in Rh-identical grafts (47/269, 17%) (P = 0.01). BC was also more frequent in grafts with arterial thrombosis (9/25, 36% vs 60/319, 19%; P = 0.03) and grafts with cold ischemia time longer than 430 min (26/174, 15% vs 44/171, 26%; P = 0.01). Multivariate logistic regression confirmed that Rh graft–host nonidentical blood groups [RR = 2(1.1–3.6); P = 0.02], arterial thrombosis [RR = 2.6(1.1–6.4); P = 0.02] and cold ischemia time longer than 430 min [RR = 1.8(1–3.2); P = 0.02] were risk factors for presenting BC. Conclusion Liver transplantation using Rh graft–host nonidentical blood groups leads to a greater incidence of BC. |
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Keywords: | Liver transplantation Biliary complications Rh nonidentity |
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