Liver graft bile duct necrosis--indication for retransplantation.

The authors describe the first in Poland case of liver retransplantation in an adult recipient, in whom the indication for the procedure was bile duct necrosis following liver transplantation due to liver cirrhosis of an uncertain origin.

[Evaluation of the usefulness of the liver for transplantation based on 26 multiorgan harvests]. / Ocena przydatnosci watroby do jej transplantacji na podstawie 26 pobran wielonarzadowych.

UNLABELLED: This study is aimed at the clinical and morphological criteria of estimation of the liver harvested for transplantation. In the period from January 1996 to May 1997 our team obtained 26 livers at the multi-organ harvesting. Most of the donors were young people after the trauma of central nervous system. The liver was harvested according to the principles of Starzl's fast method with the successive preparation on the "cold table". The donor's clinical status was estimated, as well as appearance, density and colour of the organ, quality of perfusion with UW solution In 23 cases the histological examination of the harvested organ allowed to estimate the degree of steatosis, hepatocyte necrosis, vacuolar degeneration and other abnormalities. In 3 cases the graft was estimated only by means of macroscopic examination. RESULTS: As a result of clinical and histological findings 8 organs were considered as unsuitable for transplantation. In one case the histological findings were the contraindication despite the satisfactory macroscopic appearance of the organ 15 organs were successfully transplanted, proving the conformity of clinical and histological criteria. In 4 livers (15%) the abnormalities of arterial supply were found. CONCLUSIONS: Clinical and pathomorphological estimation of the harvested liver is adequate to it's suitability for transplantation, advisable for the centres initiating the liver transplantation program. Detailed analysis of the donor's clinical status and laboratory data and competent macroscopic estimation of the harvested liver allow the experienced surgeon to resign from the routine histological verification, which might be necessary in doubtful cases only.

[Correlation among clinical and histopathologic criteria in selection of donors for orthotopic liver transplantation]. / Korelacja miedzy kryteriami klinicznymi a histopatologicznymi w doborze dawców w ortotopowym przeszczepie watroby.

The aim of this work is to present the correlation between the initial microscopic pattern of the liver graft and clinical and laboratory findings. In the Department of General Surgery and Liver Diseases 6 specimens were taken from 4 livers destined for planned liver transplantations. They were taken from the organ rinsed in UW solution, processed and stained extemporaneously. Quick HE staining was performed in some cases. Two livers were qualified for transplantation although they showed negligible histopathological changes. In one of these cases there was a clinical and pathological disagreement. The results of histological examination were crucial in qualification of the liver for grafting. One organ was disqualified because of negative clinical and pathological findings, while two other livers were disqualified after clinical examination. We resigned from the transplantation of liver of the last donor, who exhibited unsatisfactory clinical tests in spite of good pathological results.