{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:03:09Z","timestamp":1790290989621,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background.<\/jats:title>\n                    <jats:p>Biliary complications represent a critical concern among live liver donors in living donor liver transplantation (LDLT), often necessitating invasive interventions. This multicenter study investigated the incidence, management, and long-term outcomes of biliary complications in living donors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>Of 6532 living donors who underwent hepatectomy at 13 LDLT centers during 2013\u20132022, those who developed biliary complications of Clavien-Dindo classification grade IIIa or higher were retrospectively analyzed for the incidence, details of complications and managements, and long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>\n                      One hundred twenty-two donors (1.9%) developed biliary complications of Clavien-Dindo classification grade IIIa or higher; biliary leakage alone (n\u2005=\u200587; 1.3%), biliary stricture alone (n\u2005=\u200518; 0.28%), combined leakage and stricture (n\u2005=\u200516; 0.24%), and other (bile duct transection, n\u2005=\u20051). The incidence was significantly higher for donors undergoing laparoscopic\/robotic surgery compared with open surgery (2.9% versus 1.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001). Biliary leakage was treated primarily by percutaneous drainage, whereas all biliary strictures were treated with endoscopic drainage. Redo surgery was performed for 19 donors (0.29% of all living donors; 15.6% of donors with biliary complications). Among 19 donors, 4 donors underwent hepaticojejunostomy. The median time to resolution of leakage, stricture, and combined was 1.2, 10, and 9.1 mo, respectively. Late complications required significantly longer to cure than early complications (4.0 versus 1.3 mo,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>Despite the acceptably low overall incidence, the present results demonstrate that biliary complications impose a considerable burden on donors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/tp.0000000000005583","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T15:00:08Z","timestamp":1765206008000},"page":"e647-e654","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Biliary Complications Requiring Interventions in Living Donor Hepatectomies: The Vanguard Multicenter Study Project of iLDLT Group"],"prefix":"10.1097","volume":"110","author":[{"given":"Ryugen","family":"Takahashi","sequence":"first","affiliation":[{"name":"Artificial Organ and Transplantation Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinsoo","family":"Rhu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagadeesh","family":"Krishnamurthy","sequence":"additional","affiliation":[{"name":"Department of Liver Transplant and Gastrointestinal Surgery, Centre for Liver and Biliary Sciences, Max Super Specialty Hospital, Saket, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukesh Kumar","family":"Olaniya","sequence":"additional","affiliation":[{"name":"Department of Liver Transplant and Gastrointestinal Surgery, Centre for Liver and Biliary Sciences, Max Super Specialty Hospital, Saket, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subash","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Liver Transplant and Gastrointestinal Surgery, Centre for Liver and Biliary Sciences, Max Super Specialty Hospital, Saket, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaleen","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Liver Transplant and Gastrointestinal Surgery, Centre for Liver and Biliary Sciences, Max Super Specialty Hospital, Saket, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanobu","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nagasaki University, Nagasaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Toshima","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Sik","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Haruki","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Reis","family":"Waisberg","sequence":"additional","affiliation":[{"name":"Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wellington","family":"Andraus","sequence":"additional","affiliation":[{"name":"Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Minnee","sequence":"additional","affiliation":[{"name":"Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Zamora","family":"Valdes","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation, Navy Medical Center, Mexico City, Mexico."},{"name":"Department of Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhisa","family":"Akamatsu","sequence":"additional","affiliation":[{"name":"Artificial Organ and Transplantation Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Artificial Organ and Transplantation Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mureo","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang-Woong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Ikegami","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"R1-20260217","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1111\/j.1600-6143.2011.03972.x","article-title":"Complications of living donor hepatic lobectomy\u2014a comprehensive report.","volume":"12","author":"Abecassis","year":"2012","journal-title":"Am J Transplant"},{"key":"R2-20260217","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1002\/lt.23575","article-title":"Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world- wide 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