Liver & intrahepatic bile ducts
Liver transplantation
Early onset graft injury
Liver transplantation overview
Author: Komal Arora, M.D.
Last author update: 1 May 2012
Last staff update: 14 March 2024
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Liver transplantation general
Cite this page: Arora K. Liver transplantation overview. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/livertransplantgeneral.html. Accessed December 4th, 2024.
Definition / general
- 3 year overall survival rate is 70%
- Biopsy necessary to document allograft rejection
- Common reasons for transplant: congenital biliary atresia (children), hepatitis C (adults), cholangiocarcinoma (Clin Liver Dis 2011;15:699)
- Explanted livers from patients with familial amyloidotic polyneuropathy but not apolipoprotein AI amyloidosis with Arg26 mutation can be used for other patients (domino style transplantation) (Hum Pathol 2000;31:40, Mod Pathol 2001;14:577)
- Primary EBV infection reported in 60% of EBV seronegative patients; reactivation in 20% of seropositive patients
- Monitor posttransplant lymphoproliferative disease (polyclonal B cell proliferation, B cell lymphoma) with allograft liver biopsy to detect acute rejection when the immunosuppression is reduced
- May also have surgical complications such as Budd-Chiari syndrome, portal vein thrombosis, arterial thrombosis, biliary tract complications
- Hepatitis B and C usually recur post-transplant (Hum Pathol 2000;31:101)
- Are major causes of cirrhosis (Hum Pathol 1999;30:39)
- Steatosis: microsteatosis in donor liver biopsies has no effect on graft function; ischemic injury with development of steatosis in early posttransplantation period is uncommon, may be associated with hepatitis C and poor clinical outcome (Hum Pathol 2000;31:1209)
- Preservation injury: injury to liver during period from final phase of donor's life to implantation into recipient (Transplantation 2001;71:1566)
Prognostic factors
- Combinations of centrilobular hepatocyte ballooning, dropout and cholestasis are associated with ischemic / perfusion damage early posttransplant (due to harvesting, transporting, reperfusion issues, usually reversible)
- Presence of all three is associated with poor outcome
- Central venulitis is not a prognostic factor (Hum Pathol 2002;33:270)
Case reports
- 57 year old man who accumulated Thorotrast in liver allograft 10 years after transplant (Mod Pathol 2004;17:117)
- 2 cases of extranodal MALT lymphoma posttransplant (Am J Surg Pathol 2000;24:100)
Additional references
