Hepatitis Post Cardiopulmonary Bypass in Children: Single Center Experience in Egypt

Abstract

Background: Cardiopulmonary surgery is associated with risk of liver dysfunction due to hypoperfusion, release of mediators by macrophages and drug induced liver injury. Aim of the work: to assess liver functions and sonographic changes post- cardiopulmonary bypass in children. Methods: Fifty children with congenital heart diseases who underwent cardiac surgery were assessed. Liver function tests, abdominal ultrasound and echocardiography were performed for those with impaired liver functions at 6 months and up to 18months postoperatively. Results: Among 50 studied children (30 males and 20 females); 40 underwent cardiopulmonary bypass (CPB) and 10 underwent closed heart surgery. Twelve (24%) patients had elevated liver transaminases (aspartate transaminase (AST) and alanine transaminase (ALT)). They all proved to have anti-hepatitis C virus (HCV) antibodies and positive HCV by polymerase chain reaction (PCR). Brightness of liver (20 cases), hepatomegaly (12 cases) and congested hepatic veins (10 cases) were the most important sonographic findings. Significant relation was found between elevated liver enzymes and HCV (p=0.012). There was no correlation between CPB or congenital structural defect or surgical procedure and hepatic affection (p>0.05). Conclusion: Open heart surgery may be associated with increased risk of hepatitis C infection. Increased liver brightness is the most common sonographic finding. Pre-cardiac surgery screening for HCV is mandatory in children.

Keywords

• cardiopulmonary bypass
• liver function test
• congenital heart diseases
• hepatitis c virus
• hcv