Impact of cytomegalovirus infection on biliary disease after liver transplantation - maybe an essential factor |
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Authors: | Jing-Yi Liu Jian-Rui Zhang Li-Ying Sun Zhi-Jun Zhu Lin Wei Wei Qu Zhi-Gui Zeng Ying Liu Xin-Yan Zhao |
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Affiliation: | Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;Clinical Center for Pediatric Liver Transplantation, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. moc.kooltuo@xlxnus |
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Abstract: | BACKGROUNDCytomegalovirus (CMV) infection is common in liver transplant (LT)_ recipients, and biliary complications occur in a large number of patients. It has been reported that CMV-DNA is more detectable in bile than in blood.AIMTo investigate the effects of CMV infection on biliary complications by comparing the levels of CMV-DNA in the bile and blood of patients after LT.METHODSWe conducted a retrospective analysis of 57 patients who underwent LT, 10 of these patients had no biliary complications and 47 patients had biliary complications. We also compared the levels of CMV-DNA in patients’ bile and blood, which were sampled concurrently. We used RNAscope technology to identify CMV in paraffin-embedded liver sections.RESULTSCMV-DNA was not detected in bile samples and was detected in 2 blood samples from patients without biliary complications. In the 47 patients with biliary complications, CMV-DNA was detected in 22 bile samples and 8 blood samples, both bile and blood samples were positive for CMV-DNA in 6 patients. The identification rate of CMV-DNA in blood was 17.0%, and was 46.8% in bile. Moreover, tissue samples from 4 patients with biliary complications tested positive using RNAscope technology but were negative with hematoxylin and eosin staining. During the follow-up period, graft failure occurred in 13 patients with biliary complications, 8 of whom underwent retransplantation, and 3 died. CMV-DNA in bile was detected in 9 of 13 patients with graft failure.CONCLUSIONIn patients with biliary complications, the identification rate of CMV-DNA in bile was higher than that in blood. Blood CMV-DNA negative patients with biliary complications should still be monitored for CMV-related biliary tract diseases. Potential occult CMV infection may also be a contributing etiological factor in the development of graft failure. |
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Keywords: | Liver transplantation Cytomegalovirus infection Graft failure Biliary complications RNAscope in situ hybridization Retrospective study |
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