Transplantation Pathology

Abstract

The histopathologist is involved in many stages of the liver transplantation process, including evaluation of the: (1) donor liver prior to transplantation, (2) native liver removed at transplantation, (3) baseline graft status, and 4) posttransplantation graft. The type of posttransplant complication depends on various factors, including time post transplantation, primary liver condition, and the patient’s age. For example, acute rejection affects the graft early, whereas recurrent disease occurs later. Like other types of liver disorders, the severity of rejection can be graded semiquantitatively, the commonest system used being the Banff scheme. The table below gives a brief summary of graft complications. Graft-versus-host disease (GVHD), sinusoidal obstruction syndrome/veno-occlusive disease, and drug- or viral-induced hepatitis are the most common causes of liver injury in haemopoietic transplant patients. These are described at the end of the chapter.