Pathologic diagnosis of transplantation liver puncture biopsy: clinicopathologic analysis of 906 cases/times / 中华器官移植杂志

ABSTRACT

Objective To explore the histological morphological features of complications following liver transplantation. Methods In 639 patients with complications following liver transplantation, the percutaneous liver biopsy tissues were stained by HE method. Van Gieson, Masson, PAS, reticulin and immunohistochemical staining were performed. HBsAg, HBcAg, HCVAg, CMV-EA, CMV-LA, CMV pp65, EBVAg and the expression of CK19 were detected. The rejection was graded according to Banff standard and scored with RAI.Results 906 times of liver biopsies in 639 cases were performed. Acute cellular rejection (ACR) was most commonly seen in 386 cases ( 42.61 %), followed by complication of biliary tract (251 cases, 27.70 %), drug-induced liver damage (72 cases, 7.95 %), CMV infection (55 cases, 6.07 %), infection or recurrence of hepatitis virus (B or C) (45 cases, 4.97 %), ischemia-reperfusion injury (42 cases, 4.64 %), chronic rejection (32 cases, 3.53 %), obstruction of efferent tract (6 cases, 0.66 %), recurrence of the primary affection (5 cases, 0.55 %), and non-function of live grafts (4 cases, 0.44 %). The complications in 8 cases were difficult to diagnose ( 0.88 %). Compared with the previous report of complications, the incidence rate of ACR was decreased and that of complication of biliary tract and drug-induced liver damage increased in this study. Conclusion Percutaneous liver biopsy is valuable for the diagnosis of complications. It provides the evidence of settling plan of treatment and improves the survival rate.