Electron microscopy of rejected human liver allografts

Electron microscopy of rejected human liver allografts Recognition by biopsy of liver allograft rejection has been less successful than diagnosis of rejection of cardiac and kidney allografts. In a study of 138 failed liver allografts, we recognized damage to small interlobular bile ducts by lymphocytes as the most useful indicator of the presence of rejection. This is a report of the electron microscopic features of three patients with unequivocal allograft rejection. Lymphocytes and occasional granulocytes penetrated the epithelia of interlobular bile ducts. Ducts with diameters of 30 to 60 μM were preferentially affected but ducts up to 120 μM were also occasionally involved. Point contacts between infiltrating inflammatory cells and bile duct epithelial cells were observed occasionally. Degenerative changes of bile duct epithelial cells were conspicuous and involved nuclei and cellular organelles. Degeneration was often accompanied by aggregation of dense bundles of filaments in the cytoplasm. In severely affected ducts, epithelial cell disintegration was noted. In all involved bile ducts, the basement membrane was markedly thickened. Hepatocytes were well‐preserved but contained lipid vacuoles, pigment granules, and blunted canalicular microvilli. The similarity between these observations and those seen in primary biliary cirrhosis and chronic graft‐versus‐host disease is striking. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Hepatology Wiley

Electron microscopy of rejected human liver allografts

Hepatology, Volume 5 (6) – Nov 1, 1985

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Publisher
Wiley
Copyright
Copyright © 1985 American Association for the Study of Liver Diseases
ISSN
0270-9139
eISSN
1527-3350
D.O.I.
10.1002/hep.1840050604
Publisher site
See Article on Publisher Site

Abstract

Recognition by biopsy of liver allograft rejection has been less successful than diagnosis of rejection of cardiac and kidney allografts. In a study of 138 failed liver allografts, we recognized damage to small interlobular bile ducts by lymphocytes as the most useful indicator of the presence of rejection. This is a report of the electron microscopic features of three patients with unequivocal allograft rejection. Lymphocytes and occasional granulocytes penetrated the epithelia of interlobular bile ducts. Ducts with diameters of 30 to 60 μM were preferentially affected but ducts up to 120 μM were also occasionally involved. Point contacts between infiltrating inflammatory cells and bile duct epithelial cells were observed occasionally. Degenerative changes of bile duct epithelial cells were conspicuous and involved nuclei and cellular organelles. Degeneration was often accompanied by aggregation of dense bundles of filaments in the cytoplasm. In severely affected ducts, epithelial cell disintegration was noted. In all involved bile ducts, the basement membrane was markedly thickened. Hepatocytes were well‐preserved but contained lipid vacuoles, pigment granules, and blunted canalicular microvilli. The similarity between these observations and those seen in primary biliary cirrhosis and chronic graft‐versus‐host disease is striking.

Journal

HepatologyWiley

Published: Nov 1, 1985

References

  • Histopathology of early and late hepatic allograft rejection: evidence of progressive destruction of interlobular bile ducts
    Vierling, Vierling; Fennell, Fennell
  • Human liver transplantation: analysis of data on 540 patients from four centers
    Scharschmidt, Scharschmidt

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