Περίληψη:
We examined 27 hepatectomy specimens to assess the frequency of foam
cell endovasculitis and bile duct loss in chronic rejection. Arterial
lesions, defined as total occlusion by subintimal foam cells and/or
fibromuscular proliferation, were found mainly in hilar and septal
arteries, whereas bile duct loss, defined as the absence of bile ducts
in more than 50% of portal tracts, affected mainly small tracts. Both
were found in 20 livers (74%). In two livers (7%) there was
significant bile duct loss but no arterial lesions, whilst in five cases
(19%) there were occlusive arterial lesions but no bile duct loss.
Small arteries were involved in only 10% of the cases. These results
indicate that in one-third of the cases arterial and bile duct lesions
develop independently of each other, suggesting different pathogenetic
pathways. In addition, liver biopsy may not be pathognomonic since
small arteries are involved in only 10% of cases and bile duct loss may
not be extensive. In such cases the diagnosis of chronic rejection
should only be made in the presence of progressive clinical
deterioration.
Συγγραφείς:
DELIGEORGIPOLITI, H
WHITE, DGD
CALNE, RY
