title: Rare cause of jaundice in a post liver transplant patient.
abstract: A hepatitis B virus carrier suffering from acute flare of chronic hepatitis B infection underwent deceased-donor liver transplantation. He was put on the immunosuppressive agent tacrolimus. On routine follow-up, he was found to have abnormal liver function. Computed tomography scan of the abdomen did not show any dilatation of the biliary system. Liver biopsy showed scattered microabscesses, and a microgranuloma was detected. Endoscopic retrograde cholangiography was performed and a biliary anastomotic stricture (BAS) was noted. In addition, the Chinese liver fluke, Clonorchis sinensis, was discovered. Balloon dilatation and stenting were performed. The patient was given a course of praziquantel. His liver function improved and normalized. We present the case of a liver transplant recipient with cholangitis caused by C. sinensis infestation and infection and biliary obstruction resulting from BAS.
authors.affiliation: Division of Liver Transplantation, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
authors.forename: W H
authors.initials: WH
authors.lastname: She
authors.affiliation: Division of Liver Transplantation, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
authors.forename: K S H
authors.initials: KS
authors.lastname: Chok
authors.affiliation: Department of Pathology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
authors.forename: R C L
authors.initials: RC
authors.lastname: Lo
authors.affiliation: Division of Liver Transplantation, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
authors.forename: S C
authors.initials: SC
authors.lastname: Chan
authors.affiliation: Division of Liver Transplantation, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
authors.forename: C M
authors.initials: CM
authors.lastname: Lo
mesh_terms: D002761:Cholangitis / Q000175:diagnosis / Q000469:parasitology*; D003003:Clonorchiasis / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007565:Jaundice / Q000175:diagnosis / Q000469:parasitology*; D016031:Liver Transplantation; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000469:parasitology
keywords: Clonorchis sinensis; biliary anastomotic stricture; deceased-donor liver transplantation