Hepatobiliary Infections After Solid Organ or Hematopoietic Cell Transplantation

Abstract

Liver and biliary tract infections are common after solid organ (SOT) or hematopoietic cell transplantation (HCT). SOT recipients who receive liver grafts develop more liver problems than recipients of other organs, but liver issues such as gallstones, viral infections, and cholestasis related to drugs and infection are common after kidney, lung, heart, and pancreas transplants. Hematopoietic cell recipients must also face the toxicity of myeloablative conditioning regimens, absence of cellular immunity pending engraftment, acute and chronic GVHD, and delayed immune reconstitution. When hepatobiliary problems develop after a transplant, there is a wide differential diagnosis that encompasses both infectious and noninfectious causes, and sometimes, both simultaneously.