Prognostic value of the morphological features of postperfusion liver biopsies in liver transplantation

Abstract

Purpose: The aim of this study was to show the potential prognostic effects of morphological findings for the graft function, rejection and survival by evaluating the postperfusion liver biopsies.
 Materials and Methods: Sixty-six cases who underwent cadaveric liver transplantation between 2006 and 2010 were included. The representative slides of postperfusion subcapsular wedge biopsies were evaluated for intrasinusoidal neutrophilic infiltration, microvesicular steatosis, hepatocyte swelling, hepatocellular necrosis, endothelial swelling, bile duct epithelial changes, cholangiolar proliferation and sinusoidal congestion/hemorrhage. 
 Results: Intrasinusoidal neutrophilic infiltration was grade 1 in 40 (60%), grade 2 in 24 (36%), and grade 3 in 2 cases (4%). Sinusoidal congestion/hemorrhage was detected in 25 cases (38%). The presence of grade 2-3 intrasinusoidal neutrophils was found to be significantly associated with mortality rate. The presence of sinusiodal congestion/hemorrhage was statistically related to the rejection. Furthermore, the presence of sinusiodal congestion/hemorrhage was significantly associated with shorter overall survival.
 Conclusion: Intrasinusoidal neutrophilic infiltration is promising to be a possible histopathological predictor for mortality. In addition, the presence of sinusoidal congestion can be a candidate as a prognostic factor both for rejection and overall survival based on our study.