title: Graft calcifications and dysfunction following liver transplantation.
abstract: BACKGROUND
  The molecular events, following ischemia and reperfusion (I/R) of the liver during transplantation are largely unknown. There is evidence that apoptotic and necrotic events may take place, and occasionally result in primary graft dysfunction. We herein report two cases, where significant I/R injury correlated with the development of liver calcification and primary liver dysfunction.
  
  
  METHODS
  Both patients with clinical and biochemical evidence of primary graft dysfunction demonstrated calcification at light and electron microscopy levels. In addition, one patient had macroscopic evidence of calcification on cross-sectional imaging. Both patients died secondary to the sequelae of the graft dysfunction.
  
  
  CONCLUSIONS
  Severe I/R-induced injury to the liver, clinically leads to graft dysfunction. This is due to advanced apoptotic and/or necrotic events at the hepatocyte level that may, on the most severe form, lead to calcification. The study of microcalcification at the early posttransplant period could provide insight in the events taking place following significant ischemia/reperfusion-induced injury to the graft.
authors.affiliation: Division of General Surgery/ Section of Hepatobiliary and Transplantation Surgery, Royal Victoria Hospital, McGill University Health Center, 687 Pine Avenue West, S 10,26, Montreal, Quebec, H3A 1A1, Canada. george_tzimas@hotmail.com
authors.forename: George N
authors.initials: GN
authors.lastname: Tzimas
authors.forename: Mohammad
authors.initials: M
authors.lastname: Afshar
authors.forename: Eric
authors.initials: E
authors.lastname: Chevet
authors.forename: Anouk
authors.initials: A
authors.lastname: Emadali
authors.forename: Hojatollah
authors.initials: H
authors.lastname: Vali
authors.forename: Peter P
authors.initials: PP
authors.lastname: Metrakos
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000209:etiology* / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000209:etiology* / Q000473:pathology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D015427:Reperfusion Injury / Q000209:etiology / Q000473:pathology