BILIARY COMPLICATIONS IN PEDIATRIC LIVING-RELATED LIVER-TRANSPLANTATION

Background. The goal of this study was to evaluate cause and outcome o f biliary complications occurring after pediatric living related liver transplantation (LRLT). Methods. A database of 205 pediatric patients (71 male and 134 female) undergoing 208 LRLT from June 1990 to April 1996 was reviewed. Results. The overall incidence of bile duct complic ations was 13.9% (29 patients). There were 19 bile leaks, 7 anastomoti c strictures, 8 intrahepatic biliary complications, and the bile duct was ligated inadvertently in 2 cases. Logistic regression analysis rev ealed hepatic artery thrombosis, ABO incompatible transplantation, int rapulmonary shunting in recipients, mode of artery reconstruction, and cytomegalovirus infection were ail significant risk factors for bilia ry complications. Conclusions. Avoidance of ABO incompatible transplan tation where possible, routine use of microvascular techniques for hep atic artery reconstruction to minimize the risk of artery thrombosis, earlier transplantation for patients with intrapulmonary shunt, and pr ophylaxis against cytomegalovirus infection should all reduce the rate of biliary complications after LRLT in pediatric recipients.