title: Consensus on the histopathological evaluation of liver biopsies from patients following allogeneic hematopoietic cell transplantation.
abstract: After allogeneic hematopoietic cell transplantation (alloHCT) liver biopsy is performed for enigmatic liver disorders when noninvasive diagnostic steps have failed in establishing a definitive diagnosis. This document provides an updated consensus on the prerequisites for proper evaluation of liver biopsies in alloHCT patients and the histological diagnostic criteria for liver graft-versus-host disease (GvHD). The Working Group's recommendations for the histological diagnosis of liver GvHD were derived from the peer-reviewed literature and from the consensus diagnosis of a total of 30 coded liver biopsies. Acceptance of the recommendations was tested by a survey distributed to all HCT centers in Austria, Germany and Switzerland. Consensus was achieved for biopsy indications, methods of sample acquisition and processing, reporting and interpretation of biopsy findings. As GvHD is variably treated and the treatment modalities have changed over time, the panel endorses the use of more frequent biopsies in clinical studies in order to improve the present challenging clinical and diagnostic situation.
authors.affiliation: Institute of Clinical Pathology, Medical University of Vienna, Vienna, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Stift
authors.forename: Hideo A
authors.initials: HA
authors.lastname: Baba
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Huber
authors.forename: Birgit
authors.initials: B
authors.lastname: Federmann
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Fischer
authors.forename: Annette
authors.initials: A
authors.lastname: Schmitt-Graeff
authors.forename: Herrad
authors.initials: H
authors.lastname: Baurmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Bethge
authors.forename: Peter
authors.initials: P
authors.lastname: Schirmacher
authors.forename: Fritz
authors.initials: F
authors.lastname: Wrba
authors.forename: Hildegard
authors.initials: H
authors.lastname: Greinix
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.forename: Rainer
authors.initials: R
authors.lastname: Schwerdtfeger
authors.forename: Howard M
authors.initials: HM
authors.lastname: Shulman
authors.forename: Daniel
authors.initials: D
authors.lastname: Wolff
authors.forename: Thomas
authors.initials: T
authors.lastname: Longerich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous; D055815:Young Adult