Histopathological evaluation of early postliver transplant biopsies: A single centre one-year experience
- Author:
Anab SAYYADA
1
;
Dheeraj GAUTAM
;
Lipika LIPI
;
Apeksha BHAT
;
Narendra S CHOUDHARY
;
Swapnil DHAMPALWAR
Author Information
- Publication Type:Original Article
- From: Annals of Liver Transplantation 2025;5(1):48-53
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Liver transplant (LT) is a well‑established therapeutic strategy for endstage liver diseases. In the absence of a biopsy diagnosis, it is a common practice to increase immunosuppression for raised liver function tests, which may prove harmful in a non-rejection setting, hence, an accurate histopathological diagnosis from liver biopsy plays a significant role in the management of transplant recipients.We aim to study the spectrum of histopathological findings in post-transplant graft biopsies performed within 3 months of LT.
Methods:This was a retrospective study of 81 patients who underwent LT at Medanta-The Medicity in the year 2022 and had a liver biopsy performed within 3 months following the LT. All biopsies with T cell-mediated rejection (TCMR) and antibody-mediated rejection (AMR) were graded according to the 2016 Banff criteria by two assessors in a blinded manner. Immunohistochemistry for anti-C4d (polyclonal; BioGenex, Fremont, CA, USA), anti-cytokeratin7 (clone RM416; BioSB, Santa Barbara, CA, USA), anti-cytokeratin-19 (clone RCK108; BioGenex, Fremont, CA, USA), and anti-CMV (clone 8B1.2, 1G5.2, and 2D4.2; BioSB, Santa Barbara, CA, USA) were performed wherever required.
Results:The median age of the cohort was 45.5 years with a male predominance.The main indications of LT were alcoholic liver disease (22.22%), cryptogenic cirrhosis (20.98%), non alcoholic steatohepatitis (11.11%), and hepatocellular carcinoma (7.2%). A total of 113 biopsies were performed in 81 patients. The most common histopathological findings were TCMR (n=43, 53.08%), cholestatic changes (n=19, 23.45%), cholangitis (n=16, 19.75%), and preservation/reperfusion injury (PRI) (n=13, 16.04%). Two patients who underwent ABO-incompatible LT showed AMR.
Conclusion:The most common pathological diagnosis was TCMR, followed by cholestasis, cholangitis, and PRI. A non-TCMR diagnosis was present in 28.39% of cases.
