Laboratory diagnosis and nonoperative management of biliary complications in living donor liver transplant patients

Mukund Venu, Russell D. Brown, Rita Lepe, Jamie Berkes, Scott J. Cotler, Enrico Benedetti, Giuliano Testa, Rama P. Venu

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


BACKGROUND: Biliary complications associated with living donor liver transplantation (LDLT) remain a major problem. Information regarding biochemical abnormalities helpful for the diagnosis and the nonoperative management of such complications are limited. METHODS: Adult patients who underwent LDLT were retrospectively studied for biliary complications. Clinical findings and laboratory studies, that is, serum bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase were evaluated. Diagnostic percutaneous transhepatic cholangiogram or endoscopic retrograde cholangiogram followed by therapeutic interventions such as endoscopic sphincterotomy, stone extraction, balloon dilation, or stent placement were done as indicated. Follow-up data on clinical and biochemical outcomes were assessed. RESULTS: Among the first 29 patients who underwent LDLT, 7 patients (24%) developed biliary complications. Nonoperative treatment was undertaken through endoscopic retrograde cholangiogram in 4 cases, percutaneous transhepatic cholangiogram in 3 cases with a successful clinical outcome in 6 cases (84%). All patients with biliary stricture had a bilirubin level >1.5 mg/dL with 100% sensitivity. CONCLUSIONS: A number of patients developed biliary complications after LDLT. Nonoperative treatments were successful in most patients. Elevated serum bilirubin level may be helpful in the diagnosis of biliary stricture complicating LDLT.

Original languageEnglish (US)
Pages (from-to)501-506
Number of pages6
JournalJournal of Clinical Gastroenterology
Issue number5
StatePublished - May 2007
Externally publishedYes


  • Biliary complications
  • Living donor liver transplantation

ASJC Scopus subject areas

  • Gastroenterology


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