Unique pattern of fibrosing cholestatic hepatitis after liver transplantation.
OBJECTIVE
To explore the pathological features and the differential diagnosis of recurrent HBV after liver transplantation.


METHODS
One case of liver transplantation for HBV cirrhosis was subjected to liver biopsies on time postoperatively.


RESULTS
25 days after liver transplantation, serologic HBsAg, HBeAg and HBV-DNA of the patient became negative, but HBsAg was positive again on day 58 after liver transplantation. Histopathological examination showed balloon-like changes of hepatocytes with fragmental necrosis, fibrosis in the portal areas and around the portal veins, cholestasis in some hepatocytes and canaliculi, and positive HBsAg and HBcAg with immunohistochemical staining. clinically hepatic enzyme levels progressively increased, maintained for some time, and decreased rapidly at last. Stubborn hypoproteinemia was associated with the aggregation of general condition of the patient.


CONCLUSIONS
Fibrosing cholestatic hepatitis (FCH) is a special type in recurrent infection of HBV after liver transplantation. It has a serious clinical process and specific pathological changes different from those of the usual HBV.
Chen
Jia-Wei
JW
Departments of Pathology and Surgery, First Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
Chen
Da-Zhi
DZ
Chen
Zhao-Min
ZM
D001706:Biopsy; D002779:Cholestasis / Q000473:pathology*; D019694:Hepatitis B, Chronic / Q000473:pathology* / Q000601:surgery*; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology