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Relationship of Pretransplant Hepatobiliary Disease to Bile Duct Damage Occurring in the Liver Allograft
Author(s) -
Fennell Jr Robert H. ,,
Shikes Robert H.,
Vierling John M.
Publication year - 2007
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840030114
Subject(s) - medicine , bile duct , primary biliary cirrhosis , biliary cirrhosis , gastroenterology , pathology , liver transplantation , biliary tract , cholestasis , biliary atresia , primary sclerosing cholangitis , bile duct diseases , cirrhosis , transplantation , disease , autoimmune disease
Histopathological features of nonsuppurative destructive cholangitis have been described in primary biliary cirrosis, chronic graft‐vs.‐host disease, and chronic rejection of human liver allografts. To determine whether or not susceptibility to injury of interlobular bile ducts was related to the original hepatobiliary disease requiring transplantation, we compared the histopathology of allografts transplanted into two groups of patients. The first group consisted of patients whose original hepatobiliary diseases primarily affect bile ducts: primary biliary cirrhosis, sclerosing cholangitis, and biliary atresia. The second group consisted of patients whose original hepatobiliary diseases do not result in injury to interlobular bile ducts. In 32 liver allografts studied histopatho‐logically, the original disease did not recur. Interlobular bile duct damage occurred, however, in 17 of the 32 and resembled that seen in primary biliary cirrhosis. The spectrum of bile duct injury included mononuclear inflammation of the bile duct epithelium, destruction of the bile duct epithelium, and dissolution of the bile duct. There was no relationship between the frequency or severity of bile duct damage and original hepatobiliary disease, age, sex, duration of allograft survival, or cause of death. We conclude that nonsuppurative destructive cholangitis occurs frequently in liver allografts and represents one component of allograft rejection. This lesion resembles, in many respects, that seen in primary biliary cirrhosis so that histopathological differentiation may be difficult.