Rapid increase of bile salt secretion is associated with bile duct injury after human liver transplantation

E Geuken, D Visser, F Kuipers, H Blokzijl, HGD Leuvenink, KP de Jong, PMJG Peeters, PLM Jansen, MJH Slooff, ASH Gouw, RJ Porte*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

86 Citations (Scopus)

Abstract

Background/Aims: Biliary strictures are a serious cause of morbidity after liver transplantation. We have studied the role of altered bile composition as a mechanism of bile duct injury after human liver transplantation.

Methods: In 28 liver transplant recipients, bile samples were collected daily posttransplantation for determination of bile composition. Hepatic expression of bile transporters was studied before and after transplantation. Histopathological criteria as well as biliary concentrations of alkaline phosphatase (ALP) and gamma-glutamyltransferase (gamma-GT) were used to quantify bile duct injury.

Results: Early after transplantation, bile salt secretion increased more rapidly than phospholipid secretion, resulting in high biliary bile salt/phospholipid ratio (BA/PL). In parallel with this, mRNA levels of the bile salt transporters NTCP and BSEP increased significantly after transplantation, whereas phospholipid translocator MDR3 mRNA levels remained unchanged. Bile duct injury correlated significantly with bile salt secretion and was associated with a high biliary BA/PL ratio.

Conclusions: Bile salt secretion after human liver transplantation recovers more rapidly than phospholipid secretion. This results in cytotoxic bile formation and correlates with bile duct injury. These findings suggest that endogenous bile salts have a role in the pathogenesis of bile duct injury after liver transplantation. (C) 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)1017-1025
Number of pages9
JournalJournal of Hepatology
Volume41
Issue number6
DOIs
Publication statusPublished - Dec-2004

Keywords

  • liver transplantation
  • hepatobiliary function
  • hepatoxicity
  • cholestasis
  • biliary complications
  • bile salt
  • ISCHEMIA-REPERFUSION INJURY
  • P-GLYCOPROTEIN GENE
  • BILIARY STRICTURES
  • COLD PRESERVATION
  • RAT-LIVER
  • CHOLESTASIS
  • DISEASE
  • CELLS
  • TIME
  • URSODEOXYCHOLATE

Cite this