Histopathology of early and late human hepatic allograft rejection: Evidence of progressive destruction of interlobular bile ducts

Histopathology of early and late human hepatic allograft rejection: Evidence of progressive... Cholestasis and injury of interlobular bile ducts occur during rejection of human hepatic allografts. However, knowledge of the nature and progression of bile duct injury during rejection remains incomplete. To define the role of inflammation in bile duct damage, we assessed the light microscopic appearance of hepatic tissue from selected patients in whom allograft failure was solely due to rejection. Nine patients with rejection were easily separated into two groups based on the duration of the allograft survival. The first group (early rejection) consisted of five patients in whom rejection occurred between 13 and 36 days. The second group (late rejection) consisted of four patients in whom rejection occurred between 170 and 912 days. Early rejection was characterized by distortion of bile ducts by adjacent inflammatory cell infiltrates, cytological changes of bile duct epithelial cells and occasionally by frank mononuclear cell inflammation of the epithelium with destruction of the duct. Late rejection was characterized by nonsuppurative destructive cholangitis culminating in the disappearance of interlobular bile ducts. Both groups exhibited histological cholestasis, intact limiting plates, preservation of hepatocytes and positive orcein stains for copper‐binding protein. We conclude that the dominant histopathological feature of hepatic allograft rejection is progressive, nonsuppurative destructive cholangitis. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Hepatology Wiley

Histopathology of early and late human hepatic allograft rejection: Evidence of progressive destruction of interlobular bile ducts

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
DOI
10.1002/hep.1840050603
Publisher site
See Article on Publisher Site

Abstract

Cholestasis and injury of interlobular bile ducts occur during rejection of human hepatic allografts. However, knowledge of the nature and progression of bile duct injury during rejection remains incomplete. To define the role of inflammation in bile duct damage, we assessed the light microscopic appearance of hepatic tissue from selected patients in whom allograft failure was solely due to rejection. Nine patients with rejection were easily separated into two groups based on the duration of the allograft survival. The first group (early rejection) consisted of five patients in whom rejection occurred between 13 and 36 days. The second group (late rejection) consisted of four patients in whom rejection occurred between 170 and 912 days. Early rejection was characterized by distortion of bile ducts by adjacent inflammatory cell infiltrates, cytological changes of bile duct epithelial cells and occasionally by frank mononuclear cell inflammation of the epithelium with destruction of the duct. Late rejection was characterized by nonsuppurative destructive cholangitis culminating in the disappearance of interlobular bile ducts. Both groups exhibited histological cholestasis, intact limiting plates, preservation of hepatocytes and positive orcein stains for copper‐binding protein. We conclude that the dominant histopathological feature of hepatic allograft rejection is progressive, nonsuppurative destructive cholangitis.

Journal

HepatologyWiley

Published: Nov 1, 1985

References

  • Evolution of liver transplantation
    Starzl, Starzl; Iwatsuki, Iwatsuki; Van Thiel, Van Thiel
  • Medical aspects of liver transplantation
    Van Thiel, Van Thiel; Schade, Schade; Gavaler, Gavaler
  • Human liver transplantation: analysis of data on 540 patients from four centers
    Scharschmidt, Scharschmidt
  • The transplanted kidney
    Hamburger, Hamburger; Croshier, Croshier; Descamps, Descamps
  • Pathology of liver transplantation
    Porter, Porter
  • Relationship of pretransplant hepatobiliary disease to bile duct damage occurring in the liver allograft
    Fennell, Fennell; Shikes, Shikes; Vierling, Vierling
  • Orthotopic liver transplantation: a pathological study of 63 serial liver biopsies from 17 patients with special reference to the diagnostic features and natural history of rejection
    Snover, Snover; Sibley, Sibley; Freese, Freese
  • Hepatic graft versus host disease: a study of the predictive value of liver biopsy in diagnosis
    Snover, Snover; Weisdorf, Weisdorf; Ramsay, Ramsay

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