A comparative histological analysis of early and late graft dysfunction in different time zones following living donor liver transplantation

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dc.contributor.authorRastogi, Aen_US
dc.contributor.authorPatil, Nen_US
dc.contributor.authorSrivastava, Sen_US
dc.contributor.authorRamakrishna, Gen_US
dc.contributor.authorMaiwal, Ren_US
dc.contributor.authorKumar, Gen_US
dc.contributor.authorChoudhary, AKen_US
dc.contributor.authorAlam, Sen_US
dc.contributor.authorBihari, Cen_US
dc.contributor.authorPamecha, V.en_US
dc.date.accessioned2023-08-10T07:32:57Z
dc.date.available2023-08-10T07:32:57Z
dc.date.issued2022-12
dc.description.abstractBackground: Liver biopsy plays a crucial role in evaluating allograft dysfunction. Comprehensive analysis of the histological spectrum of complications, particularly rejection, in different time zones is lacking. Aim: To evaluate the histological spectrum of rejection, in four time zones, in a large Living donor liver transplant series. Patients and Methods: Retrospective analysis of 313 biopsies for the last 10 years of living donor liver transplantation (LDLT) recipients. 123 of which had rejection as diagnosis, were redistributed in four time zones [1-early (<3), 2-intermediate (3–6), 3 and 4-late (6–12 and > 12) months] and were assessed for sixteen histological parameters. Results: Biopsies in time zone 1 (26.5%), 2 (20.7%), 3 (24.6%), and 4 (28.1%)] were nearly equal. Multiple coexistent complications existed in 12% of the cases. Rejection diagnosed in time zone groups: 1 = 22 (17.9%), 2 = 27 (22%), 3 = 36 (29.3%), and 4 = 38 (30.9%). Portal inflammation mixed type (P < 0.000), portal vein (P = 0.001) and hepatic vein endothelialitis (P < 0.000), portal eosinophils (P = 0.001), and lymphocytic bile duct damage (P = 0.01) were most pronounced in group 1. Perivenulitis without hepatic vein endothelialitis was observed (P = 0.03) in groups 3, whereas bile duct atypia (P = 0.01) and duct loss (P < 0.000) were observed in group 4. Multiple episodes of rejection displayed significant association with central perivenulitis (P = 0.002) and bile duct loss (P < 0.001). Conclusions: Histological analysis in large series of LDLT recipients highlights the spectrum of complications in different time zones. Late acute and chronic rejection occurred as early as 3 months posttransplant. Central perivenulitis and bile duct atrophy were associated with repeated episodes of rejection and deterioration.en_US
dc.identifier.affiliationsDepartment of Pathology, Institute of Liver and Biliary Sciences, Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Hepatology, Institute of Liver and Biliary Sciences, Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Statisics, Institute of Liver and Biliary Sciences, Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Paediatric Hepatology, Institute of Liver and Biliary Sciences, Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Liver Transplantation and HPB Surgery, Institute of Liver and Biliary Sciences, Delhi, Indiaen_US
dc.identifier.citationRastogi A, Patil N, Srivastava S, Ramakrishna G, Maiwal R, Kumar G, Choudhary AK, Alam S, Bihari C, Pamecha V.. A comparative histological analysis of early and late graft dysfunction in different time zones following living donor liver transplantation. Indian Journal of Pathology & Microbiology. 2022 Dec; 65(4): 802-808en_US
dc.identifier.issn0377-4929
dc.identifier.issn0974-5130
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/223347
dc.languageenen_US
dc.publisherWolters Kluwer - Medknowen_US
dc.relation.issuenumber4en_US
dc.relation.volume65en_US
dc.source.urihttps://doi.org/10.4103/ijpm.ijpm_408_21en_US
dc.subjectAcute rejectionen_US
dc.subjectchronic rejectionen_US
dc.subjectlate acute rejectionen_US
dc.subjectliver allograft biopsyen_US
dc.subjectspectrumen_US
dc.titleA comparative histological analysis of early and late graft dysfunction in different time zones following living donor liver transplantationen_US
dc.typeJournal Articleen_US
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