Preservation / Reperfusion Injury in Transplanted Liver
Definition
- Damage to the transplanted liver caused by cold or warm ischemia
Diagnostic Criteria
- Centrilobular changes (zone 3)
- Hepatocyte swelling
- Cholestasis
- Hepatocyte dropout, centrilobular > portal
- Portal changes
- Bile ductular proliferation
- Pericholangitis (neutrophils)
- Occasionally bile plugs
- May be seen up to three weeks post transplantation
- Changes diminish in severity with time post-transplant
- Similar changes can be seen in sepsis, bile duct obstruction and TPN administration
- Cold ischemia damages sinusoidal endothelium
- Hepatocytes are more sensitive to warm ischemia
Neeraja Kambham MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting : May 9, 2007