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Hepatobiliary Tract Infections

  • Jonathan Merola
  • Robert M. Mocharla
  • Alexander Z. Jow
  • Samuel H. SigalEmail author
  • Amar Safdar
Chapter

Abstract

Infections involving the hepatobiliary tract contribute to significant morbidity and mortality in solid-organ transplant recipients, particularly recipients of a hepatic allograft. Bacteria within the gastrointestinal tract may colonize a dysfunctional biliary system, thereby increasing the risk for ascending cholangitis. Additionally, infections such as cytomegalovirus or Epstein-Barr virus may trigger life-threatening acute illness and foster risk for other opportunistic infections and malignancies, respectively during the posttransplant period. Fungal and protozoal pathogens may also find refuge within the biliary tract of immunosuppressed host, and approach toward such infections often requires a combined medical and surgical intervention. Screening for clinical, subclinical, and latent infections, early institution of prophylactic drug therapy, and appropriate immunization form the central tenet for evaluation of patients being considered for allograft transplantation. A high level of suspicion for biliary tract infections or infections involving the liver in at risk allograft recipients may assist in early diagnosis and prompt initiation of effective antimicrobial therapy. Risk mitigation by lowering drug-induced immune suppression, when possible, is important for effective management of such infections. In this chapter, a comprehensive review of hepatobiliary tract infections is presented with an emphasis on complications in patients undergoing solid-organ transplantation.

Keywords

Transplant Liver Infection Bacterial Viral Opportunistic infections 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Jonathan Merola
    • 1
  • Robert M. Mocharla
    • 2
  • Alexander Z. Jow
    • 3
  • Samuel H. Sigal
    • 4
    Email author
  • Amar Safdar
    • 5
  1. 1.Department of SurgeryYale School of Medicine, Yale-New Haven HospitalNew HavenUSA
  2. 2.Division of Gastroenterology, NYU School of Medicine, Department of Internal MedicineNew YorkUSA
  3. 3.Division of GastroenterologyMid-Atlantic Kaiser Permanente Medical GroupSpringfieldUSA
  4. 4.Division of Gastroenterology and Hepatology, Department of MedicineAlbert Einstein College of Medicine, Montefiore Medical CenterBronxUSA
  5. 5.Clinical Associate Professor of Medicine, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of MedicineEl PasoUSA

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