Histologic Changes in Bone Marrow Biopsies From Liver Transplant Patients.
Liver transplant may complicated by various hematologic conditions, resulting in indication for bone marrow biopsy. Immunosuppressive therapies, specific infections, and secondary neoplasms affect bone marrow. In the present study, we evaluated the histologic spectrum of bone marrow findings in liver allograft recipients.



Of 338 patients who received liver transplants and were followed at the Başkent University, Faculty of Medicine, 44 patients underwent bone marrow biopsy. The medical and pathologic information about these patients were evaluated, including age at liver transplant, age at bone marrow biopsy, sex, primary disease, bone marrow histology, and indication for bone marrow biopsy.



Of 44 patients who required bone marrow sampling, 30 were male (68.2%), and 14 were female (31.8%). Fifteen patients (34.1%) were in pediatric age group at the time of transplant. The most common cause of liver insufficiency leading to liver transplant was viral hepatitis in 11 patients (25%), followed by cryptogenic cirrhosis in 10 patients (22.8%). The source of the graft liver was a living donor in 40 patients (90.9%). The average age at transplant was 28.8 years, and the mean age at bone marrow sampling was 29.9 years. Nineteen patients (43.2%) required bone marrow sampling within the first year after transplant. The most common histologic findings were hypocellular, and normocellular bone marrow, observed in 18 patients (40.9%) each. Six patients (13.6%) had bone marrow biopsies for staging of posttransplant lymphoproliferative disorder. Only 1 patient of the 6 with this disease (16.7%) had malignant infiltration of the bone marrow, which was a case of Burkitt lymphoma developed as posttransplant lymphoproliferative disorder, and this was the only malignant infiltration in this patient group (2.3%). Neither specific infections nor granulomatous inflammation was detected.



Bone marrow morphology has a major role in the follow-up of liver transplant patients, who may present with peripheral blood cytopenias. The present study represents the first systematic evaluation of bone marrow findings in liver allograft recipients.
From the Department of Pathology, Faculty of Medicine, Baskent University, Ankara, Turkey.
Pelin
P
Börcek
Binnaz Handan
BH
Özdemir
Çiğdem
Ç
Sercan
Eda
E
Yılmaz Akçay
Sema
S
Karakuş
Mehmet
M
Haberal
D000328:Adult; D064591:Allografts; D000740:Anemia / Q000209:etiology / Q000473:pathology; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D001855:Bone Marrow Diseases / Q000209:etiology / Q000473:pathology*; D001856:Bone Marrow Examination / Q000379:methods; D002051:Burkitt Lymphoma / Q000209:etiology / Q000473:pathology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007970:Leukopenia / Q000209:etiology / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D010198:Pancytopenia / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey