肝移植术后急性排斥反应的病理诊断--200例次肝穿刺活检的病理组织学分析

目的观察同种异体肝移值术后急性排斥反应病理组织学表现，探讨相关的病理鉴别诊断。方法对136例(200例次)同种异体肝移植术后肝组织穿刺活检明确诊断为急性排斥反应的病理组织学资料进行回顾性分析。结果同种异体肝移植术后的急性排斥反应病理组织学表现为：汇管区内炎细胞浸润136例(200例次)；小叶间静脉和(或)中央静脉内皮炎116例(170例次)；小叶间胆管上皮变性和(或)炎细胞浸润136例(200例次)；肝细胞和毛细胆管淤胆103例(151例次)；肝细胞水肿和气球样变性83例(126例次)；肝细胞嗜酸性变和点、灶性坏死76例(161例次)。结论同种异体肝移植术后肝组织穿刺活检的病理组织学变化对急性排斥反应的诊断及术后各种并发症的鉴别诊断具有重要价值。

Histologic diagnosis of acute rejection after liver transplatation--analysis of 200 case/time liver biopsis

Objective To study histologic findings of acute rejection and related pathologic differential diagnosis after allograft liver transplantation. Methods A retrospective study based on biopsy findings in 136 patients (200 times) who were diagnosed as having acute rejection was conducted.Results Histologic findings of acute rejection after liver transplantation were as follows:(a) portal inflammatory infiltrates in 136 patients (200 times); (b) endotheliitis of inter-lobular and central vein in 116 patients (180 times); (c) nonsuppurative cholangitis in 136 patients (200 times); (d) hepatocellular and canalicular cholestasis in 103 patients (151 times); (e) hepatic cells edema and ballooning changes in 83 patients(126 times); (f) acidophilic change and spotty necrosis of hepatocyte in 76 patients (161 cases). Conclusion Liver biopsy is a very important method to diagnose acute rejection and it has a significant value in differentiating various complications.