{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:31:36Z","timestamp":1792089096225,"version":"4.4.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2017,11,20]],"date-time":"2017-11-20T00:00:00Z","timestamp":1511136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,11,20]],"date-time":"2017-11-20T00:00:00Z","timestamp":1511136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>Living donor liver transplantation (LDLT) is a technically demanding endeavor, requiring command of the complex anatomy of partial liver grafts. We examined the influence of anatomic variation and reconstruction techniques on surgical outcomes and graft survival in the 9\u2010center Adult\u2010to\u2010Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Data from 272 adult LDLT recipients (2011\u20102015) included details on anatomic characteristics and types of intraoperative biliary reconstruction. Associations were tested between reconstruction technique and complications, which included first biliary complication (BC; leak, stricture, or biloma) and first vascular complication (VC; hepatic artery thrombosis [HAT] or portal vein thrombosis [PVT]). Time to patient death, graft failure, and complications were estimated using Kaplan\u2010Meier curves and tested with log\u2010rank tests. Median posttransplant follow\u2010up was 1.2 years. Associations were found between the type of biliary reconstruction and the incidence of VC (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.03) and BC (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.05). Recipients with Roux\u2010en\u2010Y hepaticojejunostomy had the highest probability of VC. Recipients with biliary reconstruction involving the use of high biliary radicals on the recipient duct had the highest likelihood of developing BC (56% by 1 year) compared with duct\u2010to\u2010duct (42% by 1 year). In conclusion, the varied surgical approaches in the A2ALL centers offer a novel opportunity to compare disparate LDLT approaches. The choice to use higher biliary radicals on the recipient duct for reconstruction was associated with more BC, possibly secondary to devascularization and ischemia. The use of Roux\u2010en\u2010Y biliary reconstruction was associated with VCs (HAT and PVT). These results can be used to guide biliary reconstruction decisions in the setting of anatomic variants and inform further improvements in LDLT reconstructions. Ultimately, this information may contribute to a lower incidence of technical complications after LDLT. <jats:italic toggle=\"yes\">Liver Transplantation 23 1519\u20131530 2017<\/jats:italic> AASLD.<\/jats:p>","DOI":"10.1002\/lt.24872","type":"journal-article","created":{"date-parts":[[2017,9,19]],"date-time":"2017-09-19T15:12:35Z","timestamp":1505833955000},"page":"1519-1530","source":"Crossref","is-referenced-by-count":50,"title":["Biliary reconstructive techniques and associated anatomic variants in adult living donor liver transplantations: The adult\u2010to\u2010adult living donor liver transplantation cohort study experience"],"prefix":"10.1097","volume":"23","author":[{"given":"Talia B.","family":"Baker","sequence":"first","affiliation":[{"name":"Living Donor Liver Program, Comprehensive Transplantation Institute, Department of Surgery,University of Chicago Medicine,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Department of Surgery,Medical College of Wisconsin,Milwaukee,WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan P.","family":"Goodrich","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health,Ann Arbor,MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Samstein","sequence":"additional","affiliation":[{"name":"Department of Surgery,Columbia University College of Physicians and Surgeons,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Pomfret","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,University of Colorado Anschutz Medical Campus,Aurora,CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Pomposelli","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,University of Colorado Anschutz Medical Campus,Aurora,CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda W.","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Department of Biostatistics,University of Michigan,Ann Arbor,MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl L.","family":"Berg","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine,Duke University Medical Center,Durham,NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean C.","family":"Emond","sequence":"additional","affiliation":[{"name":"Department of Surgery,Columbia University College of Physicians and Surgeons,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Merion","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health,Ann Arbor,MI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,11,20]]},"reference":[{"key":"lt24872-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1002\/lt.20137","article-title":"Survival after liver transplantation in the United States: a disease\u2010specific analysis of the UNOS database","volume":"10","year":"2004","journal-title":"Liver Transpl"},{"key":"lt24872-bib-0003-20240115","first-page":"12","article-title":"Longitudinal assessment of mortality risk among candidate for liver transplantation","volume":"19","year":"2003","journal-title":"Liver Transpl"},{"key":"lt24872-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/ajt.12907","article-title":"A complete treatment of adult living donor liver transplantation: a review of surgical technique and current challenges to expand indication of patients","volume":"15","year":"2015","journal-title":"Am J 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