Meta Analysis Of Risk Factors In Biliary Complications After Liver Transplantation

Objective: To explore the risk factors of biliary complications (BC) afterliver transplantation (LT), and provide a theoretical basis in reducing the rate ofclinical BC postoperative, improve the prognosis of patients treated.Methods: MEDLINE, EMBASE, Cochrane Library and four major Chinesebiomedical databases were searched from their inception until February2012.Using a defined search strategy clinical trials of risk factors of BC after LT wereidentified.Results: Twenty five studies involving9860patients were identified,including1064cases in case group (BC group) and8796cases in control group(Non-BC group). The results of meta-analysis showed that there were notsignificant differences in recipient age, recipient gander, the Model forEnd-Stage Liver Disease (MELD) score, ABO blood-type, the second warmischemia time, technique of bile duct reconstruction and cytomegalovirus infections(P>0.05). In BC group, donor age was older (P=0.03). Both the coldischemia time and the operative time were longer in BC group (P<0.0001).Living donor liver transplantation (LDLT) was associated with a higherincidence of BC,[OR1.56(1.05-2.33)]. Using T-tube for bile ductreconstruction increased incidence of postoperative BC,[OR1.89(1.30-2.73)].The incidence of BC after LT was significantly different in patients withrejection than without,[OR1.57(1.13-2.16)]. Patients with hepatic arterycomplications had a higher incidence of postoperative BC,[OR1.78(1.01-3.15)].Conclusion: The donor age, cold ischemia time, operative time, livingdonor liver transplantation, using T-tube drainage, rejection, and hepatic arterycomplications are factors affecting the risk of BC. BC after LT have norelationship with recipient age, recipient gander, the MELD score, ABOblood-type, the second warm ischemia time, technique of bile ductreconstruction, with or without cytomegalovirus infections.