Influence of hepatitis C virus infection and high virus serum load on biliary complications in liver transplantation.

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. [ABSTRACT FROM AUTHOR]