关键词:

肝移植 , 穿刺活检组织 , 病理学

Abstract:

 Objective The incidence，pathological changes and differential diagnosis of commoncomplications after liver transplantation have been studied，through a retrospective analysis of the pathological dataof 209 liver transplant biopsy tissues from a single center. Methods A total of 209 biopsies were performed in145 patients with liver transplantation from August 2013 to April 2023, at the Organ Transplantation Center of the First Hospital of Jilin University. The liver tissues were fixed with 4% neutral formaldehyde solution， embedded in paraffin and sectioned continuously， routinely HE staining， Masson， D-PAS， reticular fiber histochemical staining， CK7， CMV， C4dimmunohistochemical staining and EBER in situ hybridization were performed. Results Acute T cell-mediated rejection （TCMR） was the most common （36.84%） complication， followed by drug-induced liver injury（DILI）（23.44%） and biliary complications （14.35%）， others include Hepatitis B and Hepatitis C virus infection or recurrence，ischemia-reperfusion injury， cytomegalovirus infection， chronic rejection， plasma cell-rich rejection， vascular complications， recurrent primary disease， primary graft dysfunction， and difficult-to-diagnose liver morphology. The diagnosis of acute T cell-mediated rejection was based on portal inflammation， bile duct inflammation and venous endothelial inflammation. In 58.44% cases of TCMR， the classic“Triad” of portal area was found. In DILI， there were swelling or ballooning degeneration of hepatocytes around central vein， steatosis with different degrees， cholestasis in hepatocytes and bile canaliculi. Biliary complication was characterized by cholestasis in hepatocytes and bile canaliculi， proliferation of small bile ducts along the interface of the portal tract，and interstitial edema.Conclusion The pathological diagnosis should be made after comprehensive analysisof the clinical manifestation， laboratory examination， imaging data and medication history. 

Key words:

Liver transplantation, Needle biopsy, Pathology