[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 533
Citations 0
Invited Commentary
February 13, 2019

The Realities of Liver Transplantation and Biliary Anastomosis—Heroes, Heroics, Heels, and Healing

Author Affiliations
  • 1Division of Transplant Surgery, Department of Surgery, University of California, Davis School of Medicine, Sacramento
JAMA Surg. 2019;154(5):440. doi:10.1001/jamasurg.2018.5538

In the Trojan war, Achilles was the strongest and most capable of the Greek Heroes. Held by a single heel, his mother bathed him as an infant in the River Styx to make him all but immortal. Her hand left a seemingly trivial area unexposed, and thus became the vulnerability that led to his demise. In the battle for health, the results of liver transplant are nothing less than heroic. The final and seemingly most trivial step of completing a transplant is the biliary anastomosis; yet sadly, it often remains one of the most problematic. Indeed, since the earliest published reports, it has been termed the procedure’s Achilles’ Heel.1

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words