BILIARY LIPID-COMPOSITION AFTER LIVER-TRANSPLANTATION - EFFECT OF ALLOGRAFT FUNCTION AND CYCLOSPORINE

Biliary lipid composition and bile flow are altered after orthotopic l iver transplantation. Cyclosporine may have additional effects on bili ary lipid composition and secretion. We studied the effects of liver t ransplantation, allograft function, and cyclosporine on biliary lipids in humans, Changes in lipid composition and secretion were correlated with serum cyclosporine levels, clinical events, and allograft functi on, Bile samples were withdrawn via a T-tube at interval time points i n 17 patients during the first 3 months posttransplantation. Total and individual bile acid, cholesterol, and phospholipid were determined u sing high-performance liquid chromatography. Biliary lipid profiles we re then correlated with clinical events, serum cyclosporine levels, an d other clinical laboratory values. Biliary lipid concentrations decre ased in 3 patients during periods of graft dysfunction (acute cellular rejection, drug-induced hepatitis, and inferior vena caval thrombosis ) and increased with resolution of the graft injury, Serum cyclosporin e levels were positively correlated with total bile acid, cholesterol, and phospholipid concentrations in bile. There was no relationship be tween the composition of secreted bile acids and serum cyclosporine le vels, Bile acid, cholesterol, and phospholipid secretion were not unco upled in the presence of cyclosporine. We concluded that (1) a decreas e in biliary lipid concentrations may be an indicator of worsened graf t function in some allografts; (2) biliary lipid concentrations are co rrelated with increasing cyclosporine levels; and (3) bile acid compos ition is unchanged, and uncoupling of secretion of of her biliary lipi ds is not observed in the presence of cyclosporine, Copyright (C) 1998 by the American Association for the Study of Liver Diseases.