Biliary (cholestatic) complications in the liver graft biopsy samples early after transplantation

Česká verzia

Authors: E. Honsová
Authors place of work: Pracoviště klinické a transplantační patologie, Transplantcentrum IKEM Praha, vedoucí pracoviště prim. MU Dr. Eva Honsová, Ph. D.
Published in the journal: Vnitř Lék 2013; 59(8): 689-693
Category:

Summary

During the first three months after a liver transplant, cholestasis of various type and degree represents 1 of the most frequent morphological findings in liver graft biopsies. The morphology of cholestasis is typical for all conditions with bile duct impairment but also for other conditions with more severe impairment of hepatocytes, including rejection and recurrence of viral hepatitides. Histological diagnosis represents the gold standard in addressing liver graft dysfunction causes, and in the majority of cases it allows for distinguishing between the main categories of diseases resulting in cholestasis. Usually a combination of various changes can be identified as a cause of the liver graft dysfunction early after transplantation. Therefore, the interpretation of limited morphological characteristics, which usually represent a certain type of tissue reaction, not the cause, is complicated. The close cooperation between the hepatologist and pathologist has become a necessary prerequisite for the best possible interpretation of the morphological conclusion.

Key words:
liver transplant – cholestasis – biliary complications

Zdroje

1. Zhai Y, Busuttil RW, Kupiec- Weglinski JV. Liver ischemia and reperfusion injury: new insights into mechanisms of innate‑adaptive immune- mediated tissue inflammation. Am J Transplant 2011; 11: 1563– 1569.

2. Hübscher S. Antibody-mediated rejection in the liver allograft. Curr Opin Organ Transplant 2012; 17: 280– 286.

3. Kusumoto S, Tanaka Y, Mizokami M et al. Reactivation of hepatitis B virus following systemic chemotherapy for malignit lymphoma. Int J Hematol 2009; 90: 13– 23.

4. Honsová E, Sperl J. Fibrocholestatická hepatitida, onemocnění nejen transplantovaných pacientů. Cesk Patol 2011; 47: 55– 58.