Impact of cytomegalovirus infection on biliary disease after liver transplantation-maybe an essential factor  

作　　者：Jing-Yi Liu Jian-Rui Zhang Li-Ying Sun Zhi-Jun Zhu Lin Wei Wei Qu Zhi-Gui Zeng Ying Liu Xin-Yan Zhao 

机构地区：[1]Liver Transplantation Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China [2]Clinical Center for Pediatric Liver Transplantation,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China [3]National Clinical Research Center for Digestive Diseases,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China [4]Intensive Care Unit,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China

出　　处：《World Journal of Clinical Cases》2021年第35期10792-10804,共13页世界临床病例杂志

基　　金：The National Natural Science Foundation of China,No.81570586.

摘　　要：BACKGROUND Cytomegalovirus(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.AIM To 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.METHODS We 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.RESULTS CMV-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.CONCLUSION In 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.

关 键 词：Liver transplantation Cytomegalovirus infection Graft failure Biliary complications RNAscope in situ hybridization Retrospective study 

分 类 号：R657.3[医药卫生—外科学]