Hepatitis C virus infection as a possible risk factor for ductopenic rejection (vanishing bile duct syndrome) after liver transplantation.
Irreversible ductopenic rejection (DR) after orthotopic liver transplantation (OLT) is a major cause of late hepatic allograft failure. A variety of risk factors for DR have been postulated, but they are controversial. All transplant recipients at our institution with graft survival of more than 1 month (n = 120) were examined retrospectively with a view to possible risk factors for DR. These factors included age, sex, underlying liver disease, hepatitis B and C infections, donor-recipient CMV status, post-OLT CMV infections, immunosuppressive regimen, ABO blood type, and HLA class I and class II mismatches. Statistical analysis was performed with the univariate chi-square test or the two-tailed Fischer's exact test. Ten patients (8.3%) developed DR. Seventeen patients had HCV infections after OLT. In this group, the incidence of DR was highest (4 of 17, or 23.5%). This was significantly higher than for all other OLT groups (6 of 103 patients, or 5.8%; P < 0.03). The other factors analyzed did not reach statistical significance, including those that other authors found important for the development of DR. It may well be that hepatitis C infection predisposes one to the development of DR after OLT.
Hoffmann
R M
RM
Department of Medicine II, Klinikum Grosshadern, University of Munich, Germany.
Günther
C
C
Diepolder
H M
HM
Zachoval
R
R
Eissner
H J
HJ
Forst
H
H
Anthuber
M
M
Paumgartner
G
G
Pape
G R
GR
D001649:Bile Duct Diseases / Q000209:etiology*; D003586:Cytomegalovirus Infections / Q000150:complications; D006084:Graft Rejection; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications*; D015395:Histocompatibility Antigens Class I / Q000032:analysis; D000949:Histocompatibility Antigens Class II / Q000032:analysis; D006801:Humans; D007165:Immunosuppression Therapy; D016031:Liver Transplantation / Q000276:immunology*; D012189:Retrospective Studies; D012307:Risk Factors
D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II