A 5-year review of surgical outcomes for deceased-donor liver transplantation in British Columbia

Background: Surgical complications after liver transplantation are known to contribute to morbidity and mortality. Evaluation of complication rates is a crucial part of assessing transplant program performance and identifying areas for improvement. A study was proposed to determine complication rates and outcomes using BC Transplant data. Methods: Patients undergoing deceased-donor liver transplantation from 2007 to 2011 were identified via the prospectively and independently managed BC Transplant database. Both paper and electronic records were reviewed for 191 patients who underwent 201 individual transplant procedures. The records included operative reports, radiology studies, outpatient clinic notes, and all available follow-up information obtained at Vancouver General Hospital until 31 August 2014. Rates of surgical complications and mortality were calculated and compared with published rates from other centres. Results: The retrospective review of records revealed an in-hospital mortality rate of 5.2% and a 1-year mortality rate of 8.4%. Complications occurred in 107 of 201 transplants. Half of all patients (53.2%) experienced a reoperative, biliary, or vascular complication. The most common complications were a planned or unplanned reoperation (32.3%), a bile leak (9.0%) or anastamotic stricture (16.9%), and hepatic artery thrombosis (7.5%). Conclusions: Rates for 1-year inhospital mortality, biliary complications, and hepatic and portal vein thrombosis in deceased-donor liver transplantation in BC were similar to rates found in the literature. Rates for hepatic artery thrombosis appeared higher than those reported in the literature and further investigation is needed to identify factors that may be contributing to this complication in transplant recipients. Drs Chan and DeGirolamo are residents in general surgery at the University of British Columbia. Dr Scudamore is an associate professor in the Department of Surgery at UBC and a hepatobiliary and pancreatic surgeon at Vancouver General Hospital. Dr Chung is a professor in the Department of Surgery at UBC, head of hepatobiliary and pancreatic surgery at Vancouver General Hospital, and scientific director of the BC Transplant Society. Dr Segedi is a clinical assistant professor in the Department of Surgery at UBC and a hepatobiliary and pancreatic surgeon at Vancouver General Hospital. Dr Erb is a clinical assistant professor in the Division of Gastroenterology at UBC and a gastroenterologist at Vancouver General Hospital. Dr Yoshida is a professor in the Division of Gastroenterology at UBC and a gastroenterologist at Vancouver General Hospital. Dr Marquez is a clinical assistant professor in the Division of Gastroenterology at UBC and a gastroenterologist at Vancouver General Hospital. Dr Buczkowski is a clinical professor in the Department of Surgery at UBC and a hepatobiliary and pancreatic surgeon at Vancouver General Hospital. This article has been peer reviewed.