Biliary Complications in Living Donors after Living Donor Liver Transplantation: A Systematic Review and Meta-Analysis

Introduction: Liver transplantation (LT) is the optimal treatment for many patients with advanced liver disease,
including decompensated cirrhosis, hepatocellular carcinoma and acute liver failure. In the past, the vast majority
of liver transplant involves the use of organs from deceased donors but organ shortage remains a major obstacle
and is the main determinant of death on the waiting list. Consequently, living donor liver transplantation has been
introduced to overcome the problem of organ shortage.
Ain of work: To evaluate the outcomes regarding biliary complications in donors after liver transplantation to
identify possible risk factors for these complications.
Patients and methods: This systematic review and meta-analysis was conducted at Ain Shams Organ
Transplantation Centre (ASCOT), Faculty of Medicine, Ain Shams University Hospitals on Donors who underwent
liver transplantations in the period from 2008 until 2021 in Ain Shams Organ Transplantation Centre. This systematic
review was prepared with a careful following of the Cochrane Handbook for Systematic Reviews of Interventions.
We also adhered to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines
during the design of our study.
Results: During the study period, 500 living donors were included. Biliary complications occurred in 17 living
donors, 15 (88.2%) of whom were males (Male predominance) and two (11.8%) were females. The mean ± SD
age for the donors suffering biliary complications was 29.9 ± 7.3 years and ranged from 17.5 years to 40 years.
The overall incidence of biliary complications was 3.4% (17/500) in the studied cohort. Fourteen (2.8%)
donors suffered biliary leakage (Main complication), one (0.2%) donor suffered biliary stricture, one (0.2%)
donor had biliary collection, and one (0.2%) donor had cholangitis. None of the donors had hyperbilirubinemia.
Conclusion: biliary complications were few among these donors mostly due to good donor selection and
experienced surgeons and good surgical techniques.