Influence of hepatitis C virus infection and high virus serum load on biliary complications in liver transplantation

Transpl Infect Dis. 2013 Jun;15(3):306-13. doi: 10.1111/tid.12069. Epub 2013 Mar 15.

Abstract

Background: Biliary complications (BCs) and recurrent hepatitis C virus (HCV) infection are among the major causes of morbidity and graft loss following liver transplantation. The influence of HCV on BCs has not been definitely clarified.

Patients and methods: We performed a retrospective cohort study to analyze risk factors and outcome of post orthotopic liver transplantation (OLT) BCs in 352 liver transplant recipients over 12 years in Munich, Germany (n = 84 with HCV; living donor and re-OLT were excluded). BCs diagnosed with imaging techniques and abnormal liver enzyme pattern, requiring an intervention, were considered.

Results: In a multivariate analysis, HCV serostatus and a high pre-and post-surgery HCV RNA serum load were independent risk factors for anastomotic strictures. HCV positivity and BCs alone did not alter graft loss. HCV-positive patients with BCs, however, had a significantly worse graft outcome (P = 0.02). Non-anastomotic strictures, bile leaks, and the number of interventions needed to treat bile leaks led to worse graft outcome in all patients.

Conclusion: HCV positivity and a high HCV RNA serum load were risk factors for anastomotic strictures. BCs and HCV had an additive effect on graft loss.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biliary Tract Diseases / etiology*
  • Biliary Tract Diseases / surgery
  • Cohort Studies
  • Female
  • Graft Rejection
  • Graft Survival
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification*
  • Hepatitis C / diagnosis
  • Hepatitis C / virology*
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • RNA, Viral / blood
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Viral Load*
  • Young Adult

Substances

  • RNA, Viral