Korean J Transplant.  2022 Nov;36(Supple 1):S277. 10.4285/ATW2022.F-4184.

Biliary nonanastomosis stricture related with hepatic congestion in the right liver graft

• Choi HH
• Choi Y
• Suh KS
• Lee KW
• Yi NJ
• Hong SK
• Hong SY
• Lee S
• Lee J
• Kim J

• KMID: 2535504
• DOI: http://doi.org/10.4285/ATW2022.F-4184

Abstract

Background
Biliary nonanastomosis stricture (NAS) and passive hepatic congestion are common complications after living do-nor liver transplantation (LDLT). The former is known to be caused by ischemic cholangiopathy and the latter by impaired venous drainage, but the relationship between these two complications has not yet been reported.
Methods
We reviewed the medical records of patients who underwent LDLT using a right liver graft in a single institution from January 2011 to December 2018. A total of 198 patients who needed biliary interventions due to stricture were selected, and images taken on postoperative day 7 confirmed whether the graft was congestive. Hepatic congestion and NAS were divided into three parts: right anterior section, right posterior section, and whole right lobe.
Results
Hepatic congestion occurred in 70 patients (35.4%), 42 patients (60.0%) in AS, and 28 patients (40.0%) in NAS. After excluding AS, 16 patients (57.1%) of congestion were observed in the right anterior section and five (17.9%) in the posterior section in the remaining NAS. NAS was observed 18 (64.3%) in the right anterior section, seven (25.0%) in whole right lobe, and three (10.7%) in right posterior section. Both congestion and NAS were observed frequently in right anterior section and there was a statistical relationship between the location of congestion and NAS (P=0.02).
Conclusions
Both hepatic congestion and NAS of a right liver graft were frequently observed in the right anterior section and congestion occurring in LDLT is associated with subsequent NAS. However, an additional analysis is needed on the correlation between a right graft liver with no congestion and NAS.