Biliary Complication in Pediatric Liver Transplantation: a Single-Center 15-Year Experience

  • Chih-Yang Hsiao
  • Cheng-Maw Ho
  • Yao-Ming Wu
  • Ming-Chih HoEmail author
  • Rey-Heng Hu
  • Po-Huang Lee
Original Article



The incidence and several risk factors of biliary complication (BC) following pediatric liver transplantation (LT) are widely known, but data on long-term outcomes and management is limited. This retrospective study aimed to investigate the incidence, associated risk factors, management, and outcomes of early and late BC in pediatric LT.


This study enrolled 134 pediatric patients (< 18 years old) who underwent LT at a tertiary care center in Taiwan between January 2001 and December 2015. Diagnosis of BC was based on clinical, biochemical, and radiologic examinations. Clinical data and chart records were reviewed and compared between the groups.


Among the 134 children, 21 children (15.7%) had BC after LT. Nine children had early complications, including leakage plus stricture (n = 2), stricture only (n = 2), and leakage only (n = 5). Twelve children had late BC; all of whom had anastomotic stricture. Of the 21 patients with BC, 11 patients (52.4%) were treated without surgery. The median time of first treatment for BC was 6.5 months (range, 11 days to 6.2 years). Five of the 9 patients with early complications and two of the 12 patients with late complications died of biliary tract infection. The major risk factors of BC in pediatric LT were (1) recipient age > 2 years, (2) Kasai portoenterostomy revision, and (3) hepatic artery thrombosis.


Several risk factors of BC in pediatric LT were identified. Children with early BC appeared to have relatively unfavorable outcomes. However, late BC treated by either radiological or surgical methods appeared to have a relatively good long-term prognosis.


Biliary complications Pediatric liver transplantation Risk factors 


Author Contributions

Hsiao CY and Ho MC contributed to data collection, interpretation of data, and drafted the manuscript; Ho MC and Hu RH contributed to study concept and design; Hsiao CY, Ho CM, Wu YM, Ho MC, Hu RH, and Lee PH contributed to critical revision of the manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  • Chih-Yang Hsiao
    • 1
    • 2
  • Cheng-Maw Ho
    • 3
  • Yao-Ming Wu
    • 3
    • 4
  • Ming-Chih Ho
    • 3
    • 4
    • 5
    Email author
  • Rey-Heng Hu
    • 3
    • 4
  • Po-Huang Lee
    • 3
    • 4
  1. 1.Department of SurgeryNational Taiwan University Hospital Yun-Lin BranchDouliou City of Yun-Lin CountyTaiwan
  2. 2.Graduate Institute of Clinical Medicine, College of MedicineNational Taiwan UniversityTaipeiTaiwan
  3. 3.Department of SurgeryNational Taiwan University HospitalTaipeiTaiwan
  4. 4.College of MedicineNational Taiwan UniversityTaipeiTaiwan
  5. 5.Department of SurgeryNational Taiwan University HospitalTaipeiTaiwan

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