Hepatocellular calcification in severe ischemia-reperfusion injury in a liver allograft.
Ischemia-reperfusion injury (IR) of solid organ allografts is a consequence of ischemia resulting from disruption of blood flow during organ harvest and transportation. Histologically, this manifests as variable necrosis in a pattern similar to that seen in systemic hypoperfusion. Calcification of hepatocytes has been rarely observed in ischemic injury due to systemic shock and in two cases of severe IR, both of which were associated with graft loss and death. The authors present another case of dystrophic calcification within hepatocytes occurring in a liver allograft affected by severe IR. Biochemical stains revealed that the mineralized material was calcium phosphate (likely hydroxyapatite). By electron microscopy, the hepatocyte cytoplasm was filled with variably calcified vacuoles, a subset of which likely represented swollen mitochondria. When encountered in hepatic allograft biopsies, hepatocellular calcification is associated with ischemic injury and a poor prognosis.
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska 68198-3135, USA. gtalmon@unmc.edu
Geoffrey A
GA
Talmon
James L
JL
Wisecarver
D002114:Calcinosis / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D002130:Calcium Phosphates / Q000378:metabolism; D005260:Female; D022781:Hepatocytes / Q000378:metabolism / Q000648:ultrastructure*; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008107:Liver Diseases / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D016031:Liver Transplantation; D008875:Middle Aged; D009336:Necrosis; D015427:Reperfusion Injury / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D014617:Vacuoles / Q000648:ultrastructure
D002130:Calcium Phosphates; C020243:calcium phosphate