Abnormal liver function tests and nonspecific histopathologic findings are relatively common in the post–liver transplant setting. Whereas some cases remain idiopathic and many resolve spontaneously, some carry a risk of chronicity and long-term liver dysfunction including cirrhosis, graft loss, and death. Accurate assessment and follow-up of such findings are therefore crucial in this population.
We report a case of a 64-year-old woman who underwent liver transplantation for chronic hepatitis C infection with cirrhosis. Several months after transplantation, she underwent a liver biopsy as part of a workup for abnormal serologic studies and transaminase elevation. The biopsy showed nonspecific hepatitis. Eventually, additional serologic testing demonstrated hepatitis E viral infection.
Causes of hepatitis and other forms of posttransplant liver disease, including hepatitis E, are discussed.