Transplantationspathologie der Leber

Histopathology plays an important role in the diagnosis of graft complications following liver transplantation (LTX) and includes the diagnosis of underlying liver disease, assessment of the donor liver before LTX and control biopsies after LTX. Within the early period after LTX (time zero and first month) preservation/reperfusion injury, as well as hyperacute and acute rejection may occur. Surgical vascular or biliary complications can cause parenchymal morphological changes. Within 12 months following LTX, histological signs of opportunistic infections and chronic rejection are frequent findings and disease recurrence is typical beyond the first year. Drug toxicity in liver allograft recipients can be induced by immunosuppressive therapy or other drugs. A high percentage of adult patients reveal histological features of idiopathic chronic hepatitis 6 months after LTX. Histopathological differential diagnosis of the combined underlying causes or complications is often difficult.