HEPATITIS-C VIRUS-INFECTION AS A POSSIBLE RISK FACTOR FOR DUCTOPENIC REJECTION (VANISHING BILE-DUCT SYNDROME) AFTER LIVER-TRANSPLANTATION

Irreversible ductopenic rejection (DR) after orthotopic liver transpla ntation (OLT) is a major cause of late hepatic allograft failure. A va riety of risk factors for DR have been postulated, but they are contro versial. All transplant recipients at our institution with graft survi val of more than 1 month (n = 120) were examined retrospectively with a view to possible risk factors for DR. These factors included age, se x, underlying liver disease, hepatitis B and C infections, donor-recip ient CMV status, post-OLT CMV infections, immunosuppressive regimen, A BO blood type, and HLA class I and class II mismatches. Statistical an alysis was performed with the univariate chi-square test or the two-ta iled Fischer's exact test. Ten patients (8.3 %) developed DR. Seventee n patients had HCV infections after OLT. In this group, the incidence of DR was highest (4 of 17, or 23.5 %). This was significantly higher than for all other OLT groups (6 of 103 patients, or 5.8 %; P < 0.03). The other factors analyzed did not reach statistical significance, in cluding those that other authors found important for the development o f DR. It may well be that hepatitis C infection predisposes one to the development of DR after OLT.