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

Figure 1 Endoscopic cholangiogram showing anastomotic strictures after liver transplantation.

Figure 2 RNAscope in situ hybridization tests for the presence of cytomegalovirus in paraffin-embedded liver tissue samples. A: Positive control; B-D: Patient 3, Patient 6, Patient 10; E and F: Patient 13. We used RNAscope in situ hybridization to test for the presence of cytomegalovirus in paraffin-embedded liver sections from 8 patients who tested positive for biliary cytomegalovirus-DNA. Four patients tested positive using RNAscope technology.

Figure 3 Comparison of biliary complications and bile cytomegalovirus-DNA. In 21 patients with anastomotic stricture, 66.7% (14/21) of patients had positive bile cytomegalovirus (CMV)-DNA. In 26 patients with other biliary complications, 30.8% (8/26) of patients had positive bile CMV-DNA. These results showed that biliary anastomotic stricture was more relevant to biliary CMV infection in this study.

Figure 4 Cumulative survival rate in patients after liver transplantation. In patients with negative cytomegalovirus (CMV)-DNA bile, 1-year cumulative survival rate was 96.0%, 3-year cumulative survival rate was 91.6%, and 5-year cumulative survival rate was 86.2%. In patients with CMV-DNA positive bile, 1-year cumulative survival rate was 90.9%, and the cumulative 3- and 5-year survival rates were 75.7%. Occult CMV infection is a risk factor for chronic graft failure and mortality after liver transplant.