Sclerosing cholangitis associated to cryptosporidiosis in liver-transplanted children

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Isolation of Neonatal Extrahepatic Cholangiocytes
07:54

Isolation of Neonatal Extrahepatic Cholangiocytes

Published on: June 5, 2014

M Campos1, E Jouzdani, C Sempoux

  • 1University of Louvain, Departement de Pédiatrie, Brussels, Belgium.

European Journal of Pediatrics
|February 1, 2000
PubMed

Insights

Cryptosporidium intestinal infection can cause unexplained cholangiopathies in pediatric liver transplant recipients. This serious complication may necessitate retransplantation, highlighting the importance of identifying intestinal parasite carriage.

Area of Science:

  • Pediatric Gastroenterology and Hepatology
  • Transplant Medicine
  • Infectious Diseases

Background:

  • Pediatric liver transplantation involves complex immunosuppression protocols.
  • Post-transplant complications can include biliary issues and infections.
  • Cryptosporidium is an opportunistic intestinal parasite.

Observation:

  • Three pediatric liver transplant recipients developed diffuse cholangitis.
  • All three patients had intestinal Cryptosporidium carriage and received tacrolimus and prednisone immunosuppression.
  • No other infectious agents or vascular complications were identified.

Findings:

  • Treatment with paromomycin and reduced immunosuppression resolved Cryptosporidium carriage in all patients.
  • Bile duct reoperation was required for all three, with one developing biliary cirrhosis necessitating retransplantation.
  • All patients are alive and free of parasitic infection post-treatment.

Implications:

  • Intestinal Cryptosporidium infection should be considered in pediatric liver transplant recipients with unexplained cholangiopathy.
  • Early diagnosis and management of Cryptosporidium can mitigate severe outcomes.
  • This finding underscores the link between intestinal infections and graft health in pediatric liver transplant patients.
Abstract

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