Τίτλος:
Cholestatic syndromes in renal transplant recipients with HCV infection
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
We present two distinct types of cholestatic syndrome identified in eight renal transplant (RTx) patients with HCV infection. Four patients developed fibrosing cholestatic hepatitis (FCH) and four, vanishing bile duct syndrome (VBDS). All patients with FCH were anti-HCV (-) at the time of Tx and developed a cholestatic profile 1-4 months post-Tx, with high HCV-RNA levels. Immunosuppressive therapy was drastically reduced. Two patients died of sepsis and liver failure 16 and 18 months post-Tx, and the other two showed marked improvement and seroconverted to anti-HCV Regarding the patients with VBDS, three were anti-HCV (-) and one was anti-HCV (+)/ HBsAg (+) at the time of RTx. Two patients became anti-HCV (+) 1 year, and one patient, 3 years post-Tx. Two patients developed progressive VBDS and died of liver failure 2 and 3 years after onset, and two showed marked improvement after withdrawal of immunosuppression. In two of the patients, the progression of the disease coincided with elevation in serum HCV RNA levels. We concluded that a progressive cholestatic syndrome acquiring features of FCH or VBDS may develop in HCV-infected RTx patients. The association with high viral load implicated the virus in the pathogenesis. Drastic reduction of immunosuppression may favourably affect the outcome. © Springer-Verlag 2000.
Συγγραφείς:
Boletis, J.N.
Delladetsima, J.K.
Makris, F.
Theodoropoulou, H.
Vgenopoulou, S.
Kostakis, A.
Hatzakis, A.
Περιοδικό:
Transplant International
Αριθμός / τεύχος:
SUPPL. 1
Λέξεις-κλειδιά:
virus RNA, adult; article; bile duct disease; blood; case report; cholestasis; fatality; female; hepatitis C; human; kidney transplantation; liver failure; male; middle aged; postoperative complication; retrospective study; sepsis; syndrome; virology, Adult; Bile Duct Diseases; Cholestasis; Fatal Outcome; Female; Hepatitis C; Humans; Kidney Transplantation; Liver Failure; Male; Middle Aged; Postoperative Complications; Retrospective Studies; RNA, Viral; Sepsis; Syndrome
DOI:
10.1111/j.1432-2277.2000.tb02064.x
