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Morphology of surgical complications in liver biopsies early after transplantation


Authors: Eva Honsová
Authors‘ workplace: Pracoviště klinické a transplantační patologie, Transplantcentrum IKEM, Praha
Published in: Čes.-slov. Patol., 51, 2015, No. 4, p. 162-165
Category: Reviews Article

Overview

Early after liver transplantation, surgical/anastomotic complications of various types are more common than in other solid organ transplants. It is not only because the complications can be related to the transplant procedure, but also due to the suboptimal quality of the graft, and/or recipient health issues. The most critical early post-transplant complication is thrombosis of the hepatic artery. Findings in peripheral core needle biopsies of allograft with a thrombosed artery can be quite variable from unremarkable features, to coagulative necrosis, marked centrilobular hepatocyte swelling and biliary features with marginal ductular proliferation and/or cholangiolitis. Therefore the differential diagnosis is broad and includes almost every syndrome associated with graft dysfunction. Biliary tract is frequently the site of minor and major complications and the majority of them are ultimately attributable to ischemic injury. Complications occurring at or near the biliary anastomosis are generally more amenable to treatment than those occurring in the liver parenchyma.

Keywords:
liver transplantation – anastomotic complications – hepatic artery thrombosis – bile duct complications


Sources

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

2. Nachmany I, Dvorchik I, Devera M, et al. A validated model for predicting outcome after liver transplantation: implications on transplanting the extremely sick. Transpl Int 2013; 26: 1108-1115.

3. Iida T, Kaido T, Yagi S, et al. Hepatic arterial complications in adult living donor liver transplant recipients: a single-center experience of 673 cases. Clin Transplant 2014; 28: 1025-1030.

4. Macías-Gómez C, Dumonceau JM. Endoscopic management of biliary complications after liver transplantation: An evidence-based review. World J Gastrointest Endosc 2015; 7: 606-616.

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

Labels
Anatomical pathology Forensic medical examiner Toxicology
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