肝移植术后早期临床病理分析

目的：对肝移植早期常见并发症及其临床和病理特征进行分析。方法：收集该院13例肝移植病例临床资料和肝移植后1个月内肝活检标本15份，采用10％的中性甲醛固定，石蜡包埋切片，苏木精—伊红染色，光镜观察。结果：13例1个月内穿刺活检标本15份中，病理表现为中央静脉周围肝细胞气球样变性和淤胆8例；急性排斥反应1例；组织严重缺血性坏死1例；由肝细胞气球样变和淤胆转变为肝细胞严重缺血性坏死1例；穿刺失败1例。结论：肝移植术后活检，应采用经皮穿刺活检，所取标本中至少含有5个门管区；移植后早期，因保存和再灌注损伤等所致的缺血，致使肝细胞气球样变性和淤胆较常见；同时急性排斥反应及其他原因也是导致移植早期肝功能异常的原因。

Liver transplantation:an early clinicopathological study

Objective: To study and explore the early clinicopathological characters and complications by liver biopsy after liver transplantation. Methods:Fifteen liver biopsies from 13 patients were performed in one month after liver transplantation. The liver biopsy samples were preserved in 10% buffered formalin, embedded in paraffin and stained with H-E. All the samples were assessed by light microscopy. Results: The patients included 11 males and 2 females, median 48 years old. Chronic hepatitis B with cirrhosis was the major indication for liver transplantation. Fifteen liver biopsies from 13 patients were assessed. Of the 8 specimens presented hepatocellular ballooning and cholestasis around central vein, one with acute cellular rejection, one with severe ischaemic necrosis. One of them showed that hepatocellular ballooning and cholestasis progressed to necrosis. One biopsy failed. Conclusion:At least 5 portal tracts in liver transplantation biopsy were necessary for analysis. Hepatocellular ballooning and cholestasis which caused from hepatocytic ischemia were common in early post-transplantation. The acute rejection and other causes could result in liver graft dysfunction.