The role of histopathology in hepatic transplantation.
In hepatic transplantation, the recipient and the graft must manage a difficult symbiosis. The causes that can unbalance the mutual adaptation are various, but the clinical-biochemical hepatic graft syndromes they produce are not specific. Morphological study of the graft shows a distinct pattern for each type of dysfunction etiopathogeny. Such study may find: (1) immune attack: acute rejection or chronic rejection; (2) technical complications in the biliary tract or in the blood perfusion of the graft; (3) nonspecific cholestasis secondary to graft cold ischemia or preceding development of chronic rejection; (4) recurrence of the previous illness: graft infected by hepatitis virus; (5) opportunistic viral infections (cytomegalovirus, Epstein-Barr virus, herpesvirus, adenovirus); (6) reactions to drugs and toxics; and (7) combinations of several etiologies. Morphological knowledge enables the pathologist to collaborate in hepatic transplantation programs: elaborating protocols, selecting patients, diagnosing hepatic graft dysfunction, and assessing program quality.
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Department of Pathology, Hospital Universitario Doce de Octubre, Universidad Complutense, Madrid, Spain.
D006084:Graft Rejection; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology / Q000473:pathology*