Document Detail


The effect of smoking on biliary complications following liver transplantation.
MedLine Citation:
PMID:  20735768     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
We sought to estimate the effect of smoking on the biliary complication rate following orthotopic liver transplantation. We retrospectively evaluated the records of liver transplant recipients at our center from July 1, 1999 to October 26, 2007. Using Cox proportional hazards models, we estimated the time to the earliest biliary complication (leak or stricture) based on smoking exposure, as active, former, or lifetime nonsmoker, adjusting for other clinical factors. Overall, 409 liver transplant recipients were evaluated. The overall biliary complication rate was 37.7% (n = 154). Biliary complications included 66 anastomotic leaks, 60 anastomotic strictures, and 28 nonanastomotic lesions. ERCP was the primary diagnostic modality (n = 112). 18.1% of liver transplant recipients were active smokers (n = 74) and 42.8% were former smokers (n = 175). Active smokers were at greatest risk for biliary complications on unadjusted analysis (P = 0.022). After multivariable adjustment, active smokers had a 92% higher rate of biliary complication rates compared with lifetime nonsmokers (HR 1.92, 95% CI 1.07-3.43), but no difference was noted in the rate of complication resolution. Smoking clearly portends a significant risk of biliary complications following liver transplantation. Smoking status should be clearly defined when evaluating transplant candidacy and in counseling patients with cirrhosis.
Authors:
Amit K Mathur; David N Ranney; Shaun P Patel; Dennis S Lee; Filip Bednar; Raymond J Lynch; Theodore H Welling; Michael J Englesbe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  24     ISSN:  1432-2277     ISO Abbreviation:  Transpl. Int.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  58-66     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Journal compilation © 2010 European Society for Organ Transplantation.
Affiliation:
Division of Transplantation, Department of Surgery, University of Michigan, Ann Arbor, MI, USA. amitmath@med.umich.edu
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