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J Gastrointest Surg. 2007 Apr;11(4):458-63.

Liver transplantation across Rh blood group barriers increases the risk of biliary complications.

Author information

1
Department of Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain. jbusquets@csub.scs.es

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.

Comment in

PMID:
17436130
PMCID:
PMC1852383
DOI:
10.1007/s11605-007-0116-0
[Indexed for MEDLINE]
Free PMC Article

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