Histological examination and evaluation of donor bile ducts received during orthotopic liver transplantation--a morphological clue to ischemic-type biliary lesion?
Ischemic-type biliary lesions (ITBL) belong to a group of biliary disorders that are regarded as the major complication in patients with orthotopic liver transplantation (OLT). We performed histological evaluation of donor common bile ducts received during OLT to find morphological clues to the path...
| Publicado en: | Virchows Archiv: European Journal of Pathology Vol. 461; no. 1; pp. 41 - 49 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jul2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104444486&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104444486 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09456317 O1Z jtl: Virchows Archiv: European Journal of Pathology issn: 09456317 maglogo: N pubinfo: dt: Jul2012 vid: 461 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104444486 NLM22588496 2011753450 10.1007/s00428-012-1245-8 NLM22588496 104444486 ppf: 41 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Histological examination and evaluation of donor bile ducts received during orthotopic liver transplantation--a morphological clue to ischemic-type biliary lesion? aug: au: Hansen T Hollemann D Pitton MB Heise M Hoppe-Lotichius M Schuchmann M Kirkpatrick CJ Otto G Hansen, Torsten Hollemann, David Pitton, Michael B Heise, Michael Hoppe-Lotichius, Maria Schuchmann, Marcus Kirkpatrick, C James Otto, Gerd affil: Institute of Pathology, University of Mainz, Langenbeckstr. 1, 55131 Mainz, Germany sug: subj: Bile Ducts Blood Supply Bile Ducts Pathology Liver Transplantation Postoperative Complications Pathology Adult Aged Female Ischemia Pathology Liver Diseases Surgery Male Middle Age Transplant Donors Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Ischemic-type biliary lesions (ITBL) belong to a group of biliary disorders that are regarded as the major complication in patients with orthotopic liver transplantation (OLT). We performed histological evaluation of donor common bile ducts received during OLT to find morphological clues to the pathomechanisms of ITBL. We investigated 93 grafts of 92 patients (recipients: mean age, 56.5 years; underlying disease: hepatocellular carcinoma (n = 45), alcoholic cirrhosis (n = 16), viral hepatitis with cirrhosis (n = 9), retransplantations (n = 9), others (n = 14); donors: mean age, 53.2 years). Donor common bile ducts were received after recirculation of the hepatic artery prior to biliary end-to-end anastomosis and routinely processed. Statistical evaluation was performed by chi-square analysis and multivariate analysis using a logistic regression model. With regard to ITBL (observed in 19.4 %), the following phenomena were found to be statistically relevant: necrosis of the bile duct wall, arteriolonecrosis, vascular lesions (such as subintimal edema), and intramural bleeding (P < 0.001, P < 0.001, P = 0.029, and P = 0.031, respectively). In logistic regression analysis, arteriolonecrosis was the only parameter with significance (P = 0.001). Based on these results on the morphology of the donor common bile duct, we conclude that these phenomena of vascular damage, reflecting microangiopathy, play a major role in the pathogenesis of ITBL. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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