HCV INFECTION IS NOT A RISK FACTOR FOR DEVELOPMENT OF BILIARY DUCT COMPLICATIONS POST LIVER TRANSPLANTATION

P Wong¹, J Barkun², M Deschenes¹

Divisions of Hepatology¹ and Surgery², McGill University, Montreal, Quebec

BACKGROUND: Biliary strictures or leaks occur in 10-30% of all liver transplant (OLT) recipients. Hepatitis C virus (HCV) has been isolated from biliary epithelium as well as hepatocytes, and whether HCV infection predisposes patients to biliary complications post-OLT is not known.
OBJECTIVE: To evaluate the association between disease etiology and the development of biliary complications post-OLT.
METHODS: All liver transplant recipients between 1990 - 2002 at the McGill University Health Centre were eligible for this retrospective cohort study. Information was obtained on 325 transplant recipients and analyzed using logistic regression techniques. The main outcome variable was development of a biliary complication, either a stricture or a leak. Study variables examined were age, year of surgery, cold ischemia time (CIT), gender, presence of hepatic artery thrombosis (HAT), CMV infection, and disease indication for transplantation (HBV, HCV, alcohol, cholestatic liver disease, tumor, or retransplantation).
RESULTS: Biliary complications occurred in 104 (32.0%) of all liver transplant recipients. Patients' with a history of CMV infection had a 1.86´ higher risk of developing a biliary complication than those without infection. CIT was included in the model to control for its confounding effect, and the risk of developing a biliary complication was 3.3% for each hour before the organ is transplanted. The risk of developing a biliary complication was 1.93X greater in the patient with the longest CIT (1210 minutes) vs. the patient with the shortest time (1 minute). The variables gender, age, date of transplantation, HAT and disease indication for surgery, and specifically - HCV infection, were not significant factors.
CONCLUSIONS: Patients transplanted for HCV infection are not more at risk of developing a biliary complication than other disease indications.