Observational studyLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2017
Biliary reconstructive techniques and associated anatomic variants in adult living donor liver transplantations: The adult-to-adult living donor liver transplantation cohort study experience.
Observational study in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Complexity and heterogeneity of vascular anatomy in gastric cancer surgery: a multicenter retrospective cohort study.Journal of robotic surgery · 2026Article
- Pre-operative assessment of living liver donors' liver anatomy and volumes.Updates in surgery · 2025Review
- American perspectives for LDLT in 2024.Updates in surgery · 2025Review
- Comparison of intraoperative biliary anastomosis stenting technique in living-donor liver transplantation: Review of 41 patients.Turkish journal of medical sciences · 2022Review
- Reconstruction of Separated Intrahepatic Ducts Using the Cystic and Common Hepatic Ducts in Right-Lobe Living-Donor Liver Transplantation: Experiences of Surgical Techniques, Biliary Complications, and Outcomes in a Single Institution.Annals of transplantation · 2022Article
- A rare hepatic artery variant reporting and a new classification.Frontiers in surgery · 2022Article
- Biliary complications in recipients of living donor liver transplantation: A single-centre study.World journal of hepatology · 2021Article
- Circuitous Path to Live Donor Liver Transplantation from the Coordinator's Perspective.Journal of personalized medicine · 2021Article
- Bile acid-activated macrophages promote biliary epithelial cell proliferation through integrin αvβ6 upregulation following liver injury.The Journal of clinical investigation · 2021Article
- Bile duct reconstruction using scaffold-free tubular constructs created by Bio-3D printer.Regenerative therapy · 2021Article
- Autologous Adipose Tissue-Derived Mesenchymal Stem Cells Introduced by Biliary Stents or Local Immersion in Porcine Bile Duct Anastomoses.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2020Article
- Risk factors of hepatic artery thrombosis in pediatric deceased donor liver transplantation.Pediatric surgery international · 2019Article
- Effects of infection on post-transplant outcomes: living versus deceased donor liver transplants.Clinical and experimental hepatology · 2018Article
- Complex Reconstruction of Right-Lobe Grafts on the Bench: Portal Vein, Anterior Sector Hepatic Veins, Inferior Hepatic Veins and Multiple Bile Ducts.Journal of clinical and experimental hepatologyReview
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Living donor liver transplantation (LDLT) is a technically demanding endeavor, requiring command of the complex anatomy of partial liver grafts. We examined the influence of anatomic variation and reconstruction techniques on surgical outcomes and graft survival in the 9-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Data from 272 adult LDLT recipients (2011-2015) included details on anatomic characteristics and types of intraoperative biliary reconstruction. Associations were tested between reconstruction technique and complications, which included first biliary complication (BC; leak, stricture, or biloma) and first vascular complication (VC; hepatic artery thrombosis [HAT] or portal vein thrombosis [PVT]). Time to patient death, graft failure, and complications were estimated using Kaplan-Meier curves and tested with log-rank tests. Median posttransplant follow-up was 1.2 years. Associations were found between the type of biliary reconstruction and the incidence of VC (P = 0.03) and BC (P = 0.05). Recipients with Roux-en-Y hepaticojejunostomy had the highest probability of VC. Recipients with biliary reconstruction involving the use of high biliary radicals on the recipient duct had the highest likelihood of developing BC (56% by 1 year) compared with duct-to-duct (42% by 1 year). In conclusion, the varied surgical approaches in the A2ALL centers offer a novel opportunity to compare disparate LDLT approaches. The choice to use higher biliary radicals on the recipient duct for reconstruction was associated with more BC, possibly secondary to devascularization and ischemia. The use of Roux-en-Y biliary reconstruction was associated with VCs (HAT and PVT). These results can be used to guide biliary reconstruction decisions in the setting of anatomic variants and inform further improvements in LDLT reconstructions. Ultimately, this information may contribute to a lower incidence of technical complications after LDLT. Liver Transplantation 23 1519-1530 2017 AASLD.
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