Korean J Transplant.  2022 Nov;36(Supple 1):S234. 10.4285/ATW2022.F-3756.

Early biliary leakage after liver transplantation: a single center study

• Byambaragchaa M
• Radnaabazar M
• Chogsom M
• Amankyeldi Y
• Batdelger A

• KMID: 2535451
• DOI: http://doi.org/10.4285/ATW2022.F-3756

Abstract

Background
Liver transplantation (LT) is the gold standard treatment for patients with end-stage liver disease. In Mongolia, the main reason for LT is Liver cancer and HBV, HCV related LC. Liver cancer is by far the leading cancer in Mongolia, contrib-uting almost two-fifths of the total cancer burden. National Cancer Center (NCC) is the second LT center in Mongolia. NCC of Mongolia was performed first LDLT for HCC patient in January 2018 collaborating with Samsung Medical Center of Korea.
Methods
Retrospective review of prospectively collected data study sample; 50 living donor and 10 deceased donor LT recipients, transplanted in the National Cancer Center, Ulaanbaatar, Mongolia, between January 2018 and July 2022. Collected data before and after transplant are age, BMI, indication, MELD score, type of allograft, type of anastomosis, biliary complications, management of these complications and survival BC's included: early biliary leaks.
Results
Fifty patients underwent LDLT, 10 patients underwent DDLT. There was not a split liver graft in DDLT patient. Median follow-up time was 49. Average recipient age was 48. All patients were transplanted for end stage liver disease or hepatocellu-lar carcinoma MELD-Na score was used to prioritize patients for graft allocation. One-month, 6-month, 1-year and 3-year sur-vival rates were 100%, 91.3%, 87% and 81%. Fourteen (23.3%) biliary leakage occurred during follow-up. With biliary fistula (BF) were surgically treated in four patients who underwent hepatico-jejunostomy. Two patients were with favorable outcome. With BF were surgically treated in two patients who underwent re-anastomosis with internal tube, one patient was favorable out-come eight patients with BF were treated. By ERCP stent placement in six patients. Two patients; early after transplant, by PCD in bilioma, after 3 months stent placement by ERCP.
Conclusions
Biliary complications were recognized early and managed using diverse therapeutic modalities, ranging from minimally invasive to surgical interventions. Future efforts should be directed toward reducing the incidence of posttransplant complication.