A morphological study of the removed livers from patients receiving living donor liver transplantation for adult biliary atresia.
BACKGROUND
In liver transplantation (LT) for adult biliary atresia (BA), we often encounter a cirrhotic deformation of the native liver. We aimed to investigate a morphological study of the removed livers and the patient's clinical status.


METHODS
We examined 8 BA patients who had undergone LT in adulthood at our hospital. The presence of hypertrophic or atrophic areas of the removed liver was recorded macroscopically. We graded the microscopic findings in the porta hepatis area, a hypertrophic area, and an atrophic area, respectively. Moreover, we investigated the relationship between these morphological findings and the pre-transplant clinical status (MELD score).


RESULTS
Macroscopically, a hypertrophic area existed in central liver in all cases (8/8 cases), while an atrophic area was existed in peripheral liver (7/8 cases). Microscopically, an atrophic area was the most severely impaired, while the porta hepatis and hypertrophic area were relatively intact. The pathological score in a compensatory hypertrophic area was strongly correlated with the MELD score.


CONCLUSIONS
This study suggests that the partial shrinking is not uncommon in BA cirrhotic liver. It may be due to the imbalance of bile drainage by the different segment. The patient's pre-transplant status depends on the compensatory hypertrophic liver.
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. toshi8ru@gmail.com
Toshiharu
T
Matsuura
Kenichi
K
Kohashi
Yusuke
Y
Yanagi
Isamu
I
Saeki
Makoto
M
Hayashida
Shinichi
S
Aishima
Yoshinao
Y
Oda
Tomoaki
T
Taguchi
D000328:Adult; D001656:Biliary Atresia / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D055815:Young Adult