Influence of hepatitis C virus infection and high virus serum load on biliary complications in liver transplantation
| Autor: | Hans-Joachim Stemmler, Markus Guba, Thomas Nickel, Lorenz Frey, Markus Rentsch, P. Mandel, Michael Kaspar, Martin K. Angele, Norbert H. Gruener, C. Hopf, Ingo Kaczmarek, H. Diepolder, Bijan Raziorrouh, Manfred Stangl, Reinhart Zachoval, Sophia Horster, F.J.B. Bäuerlein, J. Eberle |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Adolescent medicine.medical_treatment Hepatitis C virus Biliary Tract Diseases Hepacivirus Anastomosis Liver transplantation medicine.disease_cause Gastroenterology Cohort Studies Young Adult Risk Factors Internal medicine Medicine Humans Young adult Aged Retrospective Studies Transplantation business.industry Graft Survival virus diseases Retrospective cohort study Middle Aged Viral Load Hepatitis C digestive system diseases Surgery Liver Transplantation surgical procedures operative Infectious Diseases Treatment Outcome RNA Viral Female business Serostatus Viral load Cohort study |
| Zdroj: | Transplant infectious disease : an official journal of the Transplantation Society. 15(3) |
| ISSN: | 1399-3062 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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