Background. Biliary complication (BC) is prevalent in pediatric liver transplantation (PLT), with reported rates from 12% to 50%. This study analyzed which factors of perioperative variables caused BCs and how BCs affected graft and patient survival in PLT.

Patients and Methods. A retrospective analysis reviewed 237 consecutive pediatric recipients from 1988 to 2015 in a Korean high-volume living donor LT (LDLT) center. The median follow-up was 80.3 (range, 28.7-153.9) months.

Results. Of these 237 patients, 23 (9.7%) patients developed BCs. The overall 1-, 5-, and 10-year patient and graft survival rates were 89.8%, 87.8%, and 86.9% and 88.2%, 86.7%, and 85.8%. The 1-, 5-, and 10-year BC-free survival rates were 91.8%, 89.8%, and 89%. There was no significant difference of both patient and graft survival rate between the patients with and without BCs (P >0.05). In multivariate analysis, type of liver transplant (LDLT 12.8% vs. whole LT; 5% vs. split LT; 2.4%), portal vein complication (26.3%), and hepatic vein complication (24%) were revealed as significant contributor to BCs.

Conclusion. Despite of BCs, graft and patient survival rates were not significantly affected. Although the rate of BC was acceptable, LDLT was one of the risk factors of BCs in PLT and meticulous technique to avoid vascular complication could also improve the outcome of biliary reconstruction.

CITATION INFORMATION: Oh D, Yi N.-J, Ahn S, Hong S, Yoon K, Kim H.-S, Kim H, Lee K.-W, Suh K.-S, Han J, Kim M, Lee J. Biliary Complications After Pediatric Liver Transplantation: A High Volume Living Donor Liver Transplantation Center Study of 237 Patients Over 27 Years. Am J Transplant. 2017;17 (suppl 3).

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