Biliary complications after orthotopic liver transplantation in rats

We recently experienced a high frequency of biliary complications after orthotopic liver transplantation in rats (22 of 25 cases (88%): biloma, 20 cases; biliary peritonitis, 2 cases). These complications seemed to be rare in general, but some researchers reported such cases and addressed them mainly through rearterialization. The biliary complications we encountered were found to be associated with necrosis of the donor bile duct and an opportunistic infection of Enterobacteriaceae. After administering appropriate antibiotics, the complications significantly diminished (2 of 25 cases (8%), P = 0.0001). The nonarterialized bile duct, which becomes ischemic soon after liver transplantation, appears to be susceptible to infections. Such opportunistic infections may prevent the development of arterial collaterals, causing bile duct necrosis and the subsequent leakage of bile juice. When biliary complications frequently occur after nonarterialized liver transplantation in rats, the possibility of an opportunistic infection should thus be considered.