Liver Graft Rejection
Hepatic pathology associated with transplantation includes the following clinical features:
Appears early, usually few weeks after transplantation.
Rare, appears within hours after the transplantation is done. Leads to haemorrhagic premature death of cells (necrosis)
most common form of rejection. Usually results due to immmunosupresssion.
Chronic Rejection :
Acute Rejection leads to chronic rejection, Results in cholestasis ( bile can not flow from liver to duodenum.
Other Complications of Liver Graft Rejection
Other complications of liver graft rejection include the following:
- Bile duct stricture: It occurs alone or in combination with portal vein thrombosis. It occurs mostly in children. It leads to death of the tissue due to blockage of blood supply (infarction)
- Common infection
- Drug induced injury:Often results due to immunosuppressants
- Recurrent diseases such as neoplastic ( new cell growth) diseases and chronic hepatitis
- Common biliary cirrhosis
Diagnosis of Liver Graft Rejection
Diagnosis is generally carried out using a combination of methods which include clinical, radiological, laboratory, and histopathological tools.
The following methods are generally followed for the diagnosis of liver graft rejection:
Percutaneous liver biopsies:
Generally obtain to study the deteriorated liver function
These are obtained according to planned schedules irrespective of liver chemistry
Fine needle Aspiration Biopsy:
Fine needle Aspiration Biopsies is carried out by an adequately experienced person.
Time Zero biopsies :
Time zero Biopsies are obtained directly at transplantation immediately after revascularization.
Diagnosis generally done by selection the any of the following 2 differential diagnoses to compare with Liver Transplant.
- Acute Hepatitis
- Chronic hepatitis liver