Analysis of Risk Factors Affecting the Development of Infection in Artificial Vascular Grafts Used for Reconstruction of Middle Hepatic Vein Tributaries in Living Donor Liver Transplantation

Abstract

To analyze the risk factors affecting the development of infection in artificial vascular grafts (AVG) used for reconstruction of middle hepatic vein (MHV) tributaries in LDLT. Between January 2009 and January 2018, 1253 right lobe LDLT were performed at our Transplant Institute, and MHV tributaries of the 640 right lobe liver grafts were reconstructed with AVG. Reconstructed MHV tributaries were removed due to AVG infection in 25 of these patients (case group; n=25). In order to determine risk factors for AVG infection, right lobe LDLT patients without AVG infections were selected as control group (n=615). Both groups were compared regarding demographic parameter, transcystic catheter usage, bile leakage, type of biliary anastomosis (duct-to duct, telescopic duct-toduct), number of graft biliary duct (=1 vs >1), number of biliary anastomosis (=1, vs >1), AVG thrombosis, AVGs type (Dacron versus PTFE). Univariate analyses were used to comparison of different variables and variables with P≤ 0.20 were taken into logistic regression model. Univariate analysis shows that statistically significant difference were found between groups regarding bile leakage (p<0.001), graft thrombosis (p=0.002), transcystic catheter (p=0.049) and AVG type (p=0.013). Variables with p≤ 0.20 were taken into logistic regression model. Multivariate analysis shows that bile leakage (OR: 13.3) and AVGs thrombosis (OR: 9.8) were determined as independent and strong risk factor for development of AVGs infection This study revealed that bile leakage and graft thrombosis are an independent and strong risk factors for infections of AVGs used for anterior sector drainage reconstruction.