A morphological study of the removed livers from patients receiving living donor liver transplantation for adult biliary atresia
A morphological study of the removed livers from patients receiving living donor liver transplantation for adult biliary atresia
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DOI：
10.1007/s00383-012-3183-6
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发表时间：
2012-12-01
影响因子：
1.8
通讯作者：
Taguchi, Tomoaki
中科院分区：
文献类型：
--
作者：
Matsuura, Toshiharu;Kohashi, Kenichi;Taguchi, Tomoaki
在成人胆道闭锁（BA）的肝移植（LT）中，我们经常遇到原生肝脏的肝硬化变形。我们的目的是研究切除肝脏的形态学研究和患者的临床状态。我们对我院8例成年期行肝移植的BA患者进行了研究。从宏观上记录了切除肝脏肥厚或萎缩区域的存在。我们分别对肝门区、肥厚区和萎缩区的显微镜检查结果进行分级。此外，我们还研究了这些形态学结果与移植前临床状态（MELD评分）之间的关系。宏观上，所有病例（8/8例）均表现为肝中央区肥厚，周围区萎缩（7/8例）。镜下，萎缩区受损最严重，肝门区和肥厚区相对完整。代偿性肥厚区病理评分与MELD评分密切相关。本研究提示部分萎缩在BA型肝硬化中并不少见。这可能是由于不同节段的胆汁引流不平衡所致。患者的移植前状态取决于代偿性肥厚肝。
In liver transplantation (LT) for adult biliary atresia (BA), we often encounter a cirrhotic deformation of the native liver. We aimed to investigate a morphological study of the removed livers and the patient's clinical status.We examined 8 BA patients who had undergone LT in adulthood at our hospital. The presence of hypertrophic or atrophic areas of the removed liver was recorded macroscopically. We graded the microscopic findings in the porta hepatis area, a hypertrophic area, and an atrophic area, respectively. Moreover, we investigated the relationship between these morphological findings and the pre-transplant clinical status (MELD score).Macroscopically, a hypertrophic area existed in central liver in all cases (8/8 cases), while an atrophic area was existed in peripheral liver (7/8 cases). Microscopically, an atrophic area was the most severely impaired, while the porta hepatis and hypertrophic area were relatively intact. The pathological score in a compensatory hypertrophic area was strongly correlated with the MELD score.This study suggests that the partial shrinking is not uncommon in BA cirrhotic liver. It may be due to the imbalance of bile drainage by the different segment. The patient's pre-transplant status depends on the compensatory hypertrophic liver.