In living-donor liver transplantation, biliary complications including bile leaks and biliary anastomotic strictures remain significant challenges, with incidences varying across different centers. This multicentric retrospective study (2016-2020) included 3633 adult patients from 18 centers and aimed to identify risk factors for these biliary complications and their impact on patient survival. Incidences of bile leaks and biliary strictures were 11.4% and 20.6%, respectively. Key risk factors for bile leaks included multiple bile duct anastomoses (odds ratio, [OR] 1.8), Roux-en-Y hepaticojejunostomy (OR, 1.4), and a history of major abdominal surgery (OR, 1.4). For biliary anastomotic strictures, risk factors were ABO incompatibility (OR, 1.4), blood loss >1 L (OR, 1.4), and previous abdominal surgery (OR, 1.7). Patients experiencing biliary complications had extended hospital stays, increased incidence of major complications, and higher comprehensive complication index scores. The impact on graft survival became evident after accounting for immortal time bias using time-dependent covariate survival analysis. Bile leaks and biliary anastomotic strictures were associated with adjusted hazard ratios of 1.7 and 1.8 for graft survival, respectively. The study underscores the importance of minimizing these risks through careful donor selection and preoperative planning, as biliary complications significantly affect graft survival, despite the availability of effective treatments.

Gastroenterology Medicine & Research Safety of Everolimus in Living Donor Liver Transplantation Recipients with Severe Renal Dysfunction with Low Estimated Glomerular Filtration Rate: Can Everolimus Help in Renal Recovery? Ashok Thorat, Long-Bin Jeng*, Horng-Ren Yang Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan *Corresponding author: Long-Bin Jeng, Organ Transplantation Center, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan Submission: December 07, 2017; Published: December 15, 2017 DOI: 10.31031/GMR.2017.01.000505 ISSN 2637-7632Volume1 Issue1