Liver allograft biopsies with histological cholestasis: a clinicopathological study of 254 cases from a single centre

Abstract

<jats:sec><jats:title>Aims</jats:title><jats:p>Liver allograft biopsy is important in the management of liver transplant (LT) recipients. Cholestasis is an indicator of liver dysfunction, and histological evidence of cholestasis can be observed in a wide range of pathological entities in the post-LT setting. In this study, we describe the clinicopathological features and significance of liver allograft biopsies with histological cholestasis over 11 years in our centre.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Liver allograft biopsies performed in Queen Mary Hospital, Hong Kong from 2004 to 2014 showing histological cholestasis were retrieved from the pathology archive. Clinical and pathological data were retrospectively reviewed and analyzed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among the 254 biopsies from 167 patients, large duct obstruction (LDO) and acute cellular rejection (ACR) were the two main aetiologies associated with cholestasis. There was a decrease in sepsis as a cause over the study duration. In cases showing cholestasis at 6 months or more after LT, LDO was more common than ACR. Over half (61%) of the 254 biopsies showed mild cholestasis. Severe panacinar cholestasis was more often observed in LDO. Mild cholestasis was most commonly observed regardless of the severity of ACR. Severe cholestasis was associated with poorer 1-year and 3-year graft survival and patient survival, as well as higher 3-month and 6-month post-biopsy mortality.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Histological cholestasis and its severity in liver allograft biopsies has clinical and prognostic significance. Our study summarizes our previous experience and provides further insights into the management of post-LT patients.</jats:p></jats:sec>

Evidence that decreased expression of sinusoidal bile acid transporters accounts for the inhibition by rapamycin of bile flow recovery following liver ischemia

“…Several previous studies have shown that rapamycin inhibits the basal rate of bile flow and the recovery of bile flow following IR (Bramow et al, 2001;Deters et al, 2002;Deters et al, 2001;Fehrenbach et al, 2003;Oswald et al, 2010;Picard et al, 2011). The latter is associated with impaired recovery of the liver following a liver transplant (Lo et al, 2018;Shiffman et al, 1991). Treatment of the liver with rapamycin and its analogues can also lead to drug-induced cholestasis under a variety of conditions (Bramow et al, 2001;Dandel et al, 2010;Pantano et al, 2010).…”

Total Hepatocytes Volume as the Survival Factor in Experimental Obstruction of the Biliary Pathways

“…Обструкция внепеченочных желчных протоков является частым проявлением таких заболеваний как: опухоли холедоха, холедохолитиаз, рак головки поджелудочной железы, хронический панкреатит, лимфопролиферативные заболевания, метастазы области ворот печени и головки поджелудочной железы. Обструктивный холестаз может приводить к развитию вторичного билиарного цирроза, печеночной недостаточности, острому либо хроническому рецидивирующему холангиту [1,2]. Гистологические проявления выраженности холестаза в печени имеют клиническое и прогностическое значение [2].…”

“…Обструктивный холестаз может приводить к развитию вторичного билиарного цирроза, печеночной недостаточности, острому либо хроническому рецидивирующему холангиту [1,2]. Гистологические проявления выраженности холестаза в печени имеют клиническое и прогностическое значение [2]. Обструкция внепеченочных желчных путей ведет к пролиферации эпителия желчных протоков и перипортальному фиброзу, что в эксперименте на крысах сопровождается увеличением массы и объема печени [3].…”