Skip to main content
Journal cover image

Surgical complications after living and deceased donor liver transplant: The NSQIP transplant experience.

Publication ,  Journal Article
Amara, D; Parekh, J; Sudan, D; Elias, N; Foley, DP; Conzen, K; Grieco, A; Braun, HJ; Greenstein, S; Byrd, C; Ko, C; Hirose, R
Published in: Clin Transplant
June 2022

This study used the prospective National Surgical Quality Improvement Program (NSQIP) Transplant pilot database to analyze surgical complications after liver transplantation (LT) in LT recipients from 2017to 2019. The primary outcome was surgical complication requiring intervention (Clavien-Dindo grade II or greater) within 90 days of transplant. Of the 1684 deceased donor and 109 living donor LT cases included from 29 centers, 38% of deceased donor liver recipients and 47% of living donor liver recipients experienced a complication. The most common complications included biliary complications (19% DDLT; 31% LDLT), hemorrhage requiring reoperation (14% DDLT; 9% LDLT), and vascular complications (6% DDLT; 9% LDLT). Management of biliary leaks (35.3% ERCP, 38.0% percutaneous drainage, 26.3% reoperation) and vascular complications (36.2% angioplasty/stenting, 31.2% medication, 29.8% reoperation) was variable. Biliary (aHR 5.14, 95% CI 2.69-9.8, P < .001), hemorrhage (aHR 2.54, 95% CI 1.13-5.7, P = .024) and vascular (aHR 2.88, 95% CI .85-9.7, P = .089) complication status at 30-days post-transplant were associated with lower 1-year patient survival. We conclude that biliary, hemorrhagic and vascular complications continue to be significant sources of morbidity and mortality for LT recipients. Understanding the different risk factors for complications between deceased and living donor liver recipients and standardizing complication management represent avenues for continued improvement.

Duke Scholars

Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

June 2022

Volume

36

Issue

6

Start / End Page

e14610

Location

Denmark

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Quality Improvement
  • Prospective Studies
  • Postoperative Complications
  • Living Donors
  • Liver Transplantation
  • Humans
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Amara, D., Parekh, J., Sudan, D., Elias, N., Foley, D. P., Conzen, K., … Hirose, R. (2022). Surgical complications after living and deceased donor liver transplant: The NSQIP transplant experience. Clin Transplant, 36(6), e14610. https://doi.org/10.1111/ctr.14610
Amara, Dominic, Justin Parekh, Debra Sudan, Nahel Elias, David P. Foley, Kendra Conzen, Arielle Grieco, et al. “Surgical complications after living and deceased donor liver transplant: The NSQIP transplant experience.Clin Transplant 36, no. 6 (June 2022): e14610. https://doi.org/10.1111/ctr.14610.
Amara D, Parekh J, Sudan D, Elias N, Foley DP, Conzen K, et al. Surgical complications after living and deceased donor liver transplant: The NSQIP transplant experience. Clin Transplant. 2022 Jun;36(6):e14610.
Amara, Dominic, et al. “Surgical complications after living and deceased donor liver transplant: The NSQIP transplant experience.Clin Transplant, vol. 36, no. 6, June 2022, p. e14610. Pubmed, doi:10.1111/ctr.14610.
Amara D, Parekh J, Sudan D, Elias N, Foley DP, Conzen K, Grieco A, Braun HJ, Greenstein S, Byrd C, Ko C, Hirose R. Surgical complications after living and deceased donor liver transplant: The NSQIP transplant experience. Clin Transplant. 2022 Jun;36(6):e14610.
Journal cover image

Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

June 2022

Volume

36

Issue

6

Start / End Page

e14610

Location

Denmark

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Quality Improvement
  • Prospective Studies
  • Postoperative Complications
  • Living Donors
  • Liver Transplantation
  • Humans
  • 3202 Clinical sciences