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(1983)
The role of clinical evaluation in graft rejection following liver transplantation
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Ductular damage in liver transplant rejection: its similarity to that of primary biliary cirrhosis and graft-versus-host disease.Pathology annual, 16 Pt 2
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Hepatic Graft Versus Host Disease: A Study of the Predictive Value of Liver Biopsy in DiagnosisHepatology, 4
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Abnormal bile duct epithelium in liver biopsies with histological signs of viral hepatitis.Acta pathologica et microbiologica Scandinavica, 76 3
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The Value of Needle Renal Allograft Biopsy I. A Retrospective Study of Biopsies Performed During Putative Rejection EpisodesAnnals of Surgery, 197
The histopathological features of orthotopic liver transplants were evaluated in 63 serial biopsy specimens from 17 patients. Biopsies were taken at the time of insertion of the liver (six biopsies), at the time of development of liver function abnormalities (11 biopsies) and as follow‐up to previously abnormal biopsies (46 biopsies). The biopsies taken at the time of insertion all showed diffuse hepatocellular ballooning with confluent areas of necrosis in one case. Biopsies taken at the time of onset of rejection (nine cases) all showed a mixed portal inflammatory infiltrate, bile duct damage and central or portal vein endothelialitis (i.e., attachment of lymphocytes to the vein endothelium). Follow‐up biopsies showed several patterns including: (i) resolution of changes of acute rejection with subsequent development of recurrent acute or chronic rejection (four cases); (ii) prolonged acute rejection simulating extrahepatic biliary obstruction (four cases); (iii) prolonged acute rejection with predominance of eosinophils simulating a drug reaction (one case); and (iv) rapidly progressive acute rejection leading to death (one case). Biopsy of the transplanted liver at the time of transplantation is useful to provide a baseline for comparison with later biopsies. Biopsy at the time of onset of changes in liver function is essential to confirm the presence of rejection prior to alteration of immunosuppression.
Hepatology – Wiley
Published: Nov 1, 1984
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