Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation

Ana M Calinescu; Sébastien Monluc; Stephanie Franchi-Abella; Dalila Habes; Gabrielle Weber; Marion F Almes; Jerome Waguet; Emmanuel Jacquemin; Virginie Fouquet; Jordi Miatello; Geraldine Hery; Catherine Baujard; Emmanuel Gonzales; Sophie Branchereau; Florent Guérin

doi:10.1186/s13104-024-06735-6

Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation

BMC Res Notes. 2024 Mar 20;17(1):86. doi: 10.1186/s13104-024-06735-6.

Authors

Ana M Calinescu^{1

2}, Sébastien Monluc³, Stephanie Franchi-Abella⁴, Dalila Habes⁵, Gabrielle Weber⁴, Marion F Almes⁵, Jerome Waguet⁴, Emmanuel Jacquemin⁶, Virginie Fouquet⁷, Jordi Miatello⁸, Geraldine Hery⁷, Catherine Baujard⁹, Emmanuel Gonzales⁶, Sophie Branchereau⁷, Florent Guérin⁷

Affiliations

¹ Paediatric Surgery Unit, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France. [email protected].
² University Center of Pediatric Surgery of Western Switzerland, Geneva University Hospitals, Division of Pediatric Surgery, University of Geneva, 6 Rue Willy Donze, 1205, Geneva, Switzerland. [email protected].
³ Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Epidemiology and Public Health Department, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
⁴ Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Pediatric Radiology Unit, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
⁵ Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Pediatric Hepatology and Pediatric Liver Transplantation Unit, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
⁶ Hépatinov, Inserm U 1193, National Reference Centre for Rare Pediatric Liver Diseases, FSMR FILFOIE, ERN RARE LIVER, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Pediatric Hepatology and Pediatric Liver Transplantation Unit, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
⁷ Paediatric Surgery Unit, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France.
⁸ Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Department of Pediatric and Neonatal Intensive Care, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
⁹ Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Anesthesia Department, Université Paris-Saclay, Le Kremlin-Bicêtre, France.

Abstract

Objectives: We aimed to analyze the risk factors for management failure of BC after pediatric liver transplantation (pLT) by retrospectively analyzing primary pLT performed between 1997 and 2018 (n = 620 patients).

Results: In all, 117/620 patients (19%) developed BC. The median (range) follow-up was 9 (1.4-21) years. Patient survival at 1, 5 and 10 years was 88.9%, 85.7%, 84.4% and liver graft survival was 82.4%, 77.4%, and 74.3% respectively. Graft not patient survival was impaired by BC (p = 0.01). Multivariate analysis identified the number of dilatation courses > 2 (p = 0.008), prolonged cold ischemia time (p = 0.004), anastomosed multiple biliary ducts (p = 0.019) and hepatic artery thrombosis (p = 0.01) as factors associated with impaired graft survival. The number of dilatation courses > 2 (p < 0.001) and intrahepatic vs anastomotic stricture (p = 0.014) were associated with management failure. Thus, repeated (> 2) radiologic dilatation courses are associated with impaired graft survival and management failure. Overall, graft but not patient survival was impaired by BC.

Keywords: Biliary complications; Pediatric liver transplantation; Repeated radiologic procedures.

MeSH terms

Child
Humans
Liver Diseases* / etiology
Liver Transplantation* / adverse effects
Postoperative Complications / diagnostic imaging
Postoperative Complications / etiology
Retrospective Studies
Risk Factors