Post-transplant biliary complications using liver grafts from deceased donors older than 70 years:Retrospective case-control study  

作　　者：Carlos Jimenez-Romero Iago Justo-Alonso Pilar del Pozo-Elso Alberto Marcacuzco-Quinto Cristina Martín-Arriscado-Arroba Alejandro Manrique-Municio Jorge Calvo-Pulido Alvaro García-Sesma Ricardo San Román Oscar Caso-Maestro 

机构地区：[1]Unit of HPB Surgery and Abdominal Organs Transplantation,`12 de Octubre´University Hospital,Madrid 28041,Spain [2]Clinical Research Unit(I+12),`12 de Octubre´University Hospital,Madrid 28041,Spain [3]Department of Radiology,`12 de Octubre´University Hospital,Madrid 28041,Spain

出　　处：《World Journal of Gastrointestinal Surgery》2023年第8期1615-1628,共14页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND The shortage of liver grafts and subsequent waitlist mortality led us to expand the donor pool using liver grafts from older donors.AIM To determine the incidence,outcomes,and risk factors for biliary complications(BC)in liver transplantation(LT)using liver grafts from donors aged>70 years.METHODS Between January 1994 and December 31,2019,297 LTs were performed using donors older than 70 years.After excluding 47 LT for several reasons,we divided 250 LTs into two groups,namely post-LT BC(n=21)and without BC(n=229).This retrospective case-control study compared both groups.RESULTS Choledocho-choledochostomy without T-tube was the most frequent technique(76.2%in the BC group vs 92.6%in the non-BC group).Twenty-one patients(8.4%)developed BC(13 anastomotic strictures,7 biliary leakages,and 1 nonanastomotic biliary stricture).Nine patients underwent percutaneous balloon dilation and nine required a Rouxen-Y hepaticojejunostomy because of dilation failure.The incidence of post-LT complications(graft dysfunction,rejection,renal failure,and non-BC reoperations)was similar in both groups.There were no significant differences in the patient and graft survival between the groups.Moreover,only three deaths were attributed to BC.While female donors were protective factors for BC,donor cardiac arrest was a risk factor.CONCLUSION The incidence of BC was relatively low on using liver grafts>70 years.It could be managed in most cases by percutaneous dilation or Roux-en-Y hepaticojejunostomy,without significant differences in the patient or graft survival between the groups.

关 键 词：Older liver Liver transplant Biliary complications Biliary strictures Septuagenarian donors Octogenarian donors 

分 类 号：R575.5[医药卫生—消化系统]