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Risk of biliary tract disease in living liver donors: A population-based cohort study
Shih-Yi Lin1,2, Cheng-Li Lin3,4, Wu-Huei Hsu1,5
1Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.
Insights
Living liver donors face a significantly increased risk of biliary tract disease compared to non-donors. This elevated risk is particularly pronounced within the first three years post-donation.
Area of Science:
- Hepatology
- Transplant Surgery
- Gastroenterology
Background:
- The long-term health implications for living liver donors are not fully understood.
- Specifically, the risk of developing biliary tract disease after liver donation requires further investigation.
Purpose of the Study:
- To investigate the association between living liver donation and the subsequent risk of biliary tract disease.
- To compare the incidence of biliary tract disease in living liver donors versus non-donors.
Main Methods:
- A retrospective cohort study utilizing the Taiwan Longitudinal Health Insurance Database (2003-2011).
- Included 1,446 adult living liver donors and a comparison group of non-donors.
- Cox proportional hazards modeling was employed to assess the risk.
Main Results:
- Living liver donors exhibited a 13.9-fold higher incidence rate of biliary tract disease compared to non-donors (10.2 vs. 0.71 per 1,000 person-years).
- The adjusted hazard ratio for biliary tract disease in living liver donors was 14.2.
- The risk was elevated regardless of comorbidities and was highest within the first 3 years post-donation (adjusted HR 22.4).
Conclusions:
- Living liver donation is associated with a substantially increased risk of developing biliary tract disease.
- The findings highlight the importance of long-term surveillance for biliary complications in living liver donors.
Background & Aims:
Whether living liver donors have a higher risk of biliary tract disease compared with non-donors remains unknown.
Methods:
Data were collected from the Taiwan Longitudinal Health Insurance Database for the 2003-2011 period. The study cohort comprised 1,446 patients aged ≥ 18 years who had served as living liver donors. The primary outcome was the incidence of biliary tract disease. Cox proportional hazards modeling was used to determine the hazard ratios.
Results:
The incidence density rate of biliary tract disease was 13.9-fold higher in the liver donor (LD) cohort than in the non-LD cohort (10.2 vs. 0.71 per 1,000 person-years), with an adjusted hazard ratio (HR) of 14.2 (95% confidence interval [CI] = 7.73-26.1). Stratified by comorbidity, the relative risk of biliary tract disease was higher in the LD cohort than in the non-LD cohort for both patients with or without comorbidity. The incidence density rate of biliary tract disease was significantly higher in the first 3 years (13.5 per 1,000 person-years in the LD cohort). The highest adjusted HR of biliary tract disease for LD patients compared with the non-LD cohort was 22.4 (95% CI = 10.8-46.1) in the follow-up ≤ 3 years.
Conclusion:
Living liver donors had a higher risk of biliary tract disease compared with non-donors.
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