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Influence of hepatitis C virus infection and high virus serum load on biliary complications in liver transplantation
Author(s) -
Horster S.,
Bäuerlein F.J.B.,
Mandel P.,
Raziorrouh B.,
Hopf C.,
Stemmler H.J.,
Guba M.,
Angele M.,
Stangl M.,
Rentsch M.,
Frey L.,
Kaspar M.,
Kaczmarek I.,
Eberle J.,
Nickel T.,
Gruener N.,
Zachoval R.,
Diepolder H.
Publication year - 2013
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12069
Subject(s) - medicine , liver transplantation , hepatitis c virus , gastroenterology , serostatus , retrospective cohort study , anastomosis , hepatitis c , cirrhosis , viral load , transplantation , surgery , virus , immunology
Background Biliary complications ( BC s) 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 BC s 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 ) BC s in 352 liver transplant recipients over 12 years in M unich, G ermany ( n = 84 with HCV ; living donor and re‐ OLT were excluded). BC s 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 BC s alone did not alter graft loss. HCV ‐positive patients with BC s, 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. BC s and HCV had an additive effect on graft loss.