title: Influence of hepatitis C virus infection and high virus serum load on biliary complications in liver transplantation.
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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Medical Department II, Ludwig-Maximilians University, Campus Grosshadern, Munich, Germany. Sophia.Horster@med.uni-muenchen.de
authors.forename: S
authors.initials: S
authors.lastname: Horster
authors.forename: F J B
authors.initials: FJ
authors.lastname: Bäuerlein
authors.forename: P
authors.initials: P
authors.lastname: Mandel
authors.forename: B
authors.initials: B
authors.lastname: Raziorrouh
authors.forename: C
authors.initials: C
authors.lastname: Hopf
authors.forename: H J
authors.initials: HJ
authors.lastname: Stemmler
authors.forename: M
authors.initials: M
authors.lastname: Guba
authors.forename: M
authors.initials: M
authors.lastname: Angele
authors.forename: M
authors.initials: M
authors.lastname: Stangl
authors.forename: M
authors.initials: M
authors.lastname: Rentsch
authors.forename: L
authors.initials: L
authors.lastname: Frey
authors.forename: M
authors.initials: M
authors.lastname: Kaspar
authors.forename: I
authors.initials: I
authors.lastname: Kaczmarek
authors.forename: J
authors.initials: J
authors.lastname: Eberle
authors.forename: T
authors.initials: T
authors.lastname: Nickel
authors.forename: N
authors.initials: N
authors.lastname: Gruener
authors.forename: R
authors.initials: R
authors.lastname: Zachoval
authors.forename: H
authors.initials: H
authors.lastname: Diepolder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000209:etiology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000175:diagnosis / Q000821:virology*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D012367:RNA, Viral