Biliary complications post-transplant significantly increase healthcare costs

9 July 2015  //  Clinical Evidence

The association between biliary complications and perioperative clinical outcomes and costs were examined in a cross-sectional analysis of national data involving 7,967 patients transplanted between 2011 and 2012. Biliary complications post liver transplantation have been shown to cause prolonged hospital stays, long-term complications, inferior quality of life, increased costs, and to potentially exacerbate the donor organ shortage.

Key results

Biliary complications were seen in 14.6% of liver transplant patients and were associated with increases in:

  • Hospital and intensive care stay (27.9 vs 19.6 mean days, p<0.001 and 12.0 vs 8.3 mean days, p<0.001, respectively)
  • In-hospital morbidity and mortality (39 vs 27%, p<0.001 and 5.8 vs 4.0%, p<0.001, respectively)
  • 30-day readmissions (14.8 vs 11.2%, p<0.001)

Biliary complications also contributed to a mean increase in in-hospital costs of $36,212 (p<0.001), primarily as a result of increased healthcare resource use: accommodations ($9,539, p<0.001), surgical services ($3,988, p<0.001), and pharmacy services ($8,445, p<0.001).

The authors concluded that effective interventions aimed at reducing biliary complications will likely have a significant impact on patient outcomes and healthcare expenditure following liver transplantation. They recommended efforts be focused on understanding salient and modifiable risk factors, while developing innovative strategies to reduce biliary complications.


Palanisamy AP, et al. J Gastrointest Surg. 2015;19(2):282–9.