Document Detail

Recurrence of primary biliary cirrhosis and development of autoimmune hepatitis after liver transplant: A blind histologic study.
MedLine Citation:
PMID:  19207586     Owner:  NLM     Status:  PubMed-not-MEDLINE    
AIM: This long-term study aimed to evaluate recurrence and evolution of primary biliary cirrhosis (PBC) after orthotopic liver transplantation (OLT).
METHODS: We reviewed "blindly" allograft biopsy specimens of women who underwent transplantation for PBC (n = 84), and women who received a transplant for chronic hepatitis C virus infection (CHCV ) (n = 108). All needle liver biopsy specimens obtained more than 6 months post-OLT were examined, including 83 specimens from 44 PBC patients and 152 specimens from 58 CHCV patients.
RESULTS: Granulomatous destructive cholangitis was found in five biopsies from four PBC patients (P = 0.0048). Non-necrotizing epithelioid cell granulomas were present in four biopsies from four PBC patients, and in two biopsies from one CHCV patient. Piecemeal necrosis (P = 0.0002), lobular necroinflammatory activity (P < 0.0001), steatosis (P < 0.0001) and fibrosis (P < 0.0001) were more prevalent in CHCV patients than PBC patients. Four PBC patients developed histologic evidence of autoimmune hepatitis (AIH), at a mean time of 3.66 years post-OLT. One of these patients had histologic features of AIH/PBC overlap syndrome. All four patients developed bridging fibrosis (n = 2) or cirrhosis (n = 2). No other PBC patient had evidence of cirrhosis after OLT.
CONCLUSIONS: Histologic findings indicative of recurrent PBC were present in 15.9% of the PBC patients undergoing biopsy in this series. However, this group of patients did not suffer significant bile duct loss or fibrosis, as compared to the control group, suggesting that recurrent PBC is a mild or slowly progressive disease. Histologic evidence of AIH was observed in allograft biopsies of some PBC patients.
Prodromos Hytiroglou; Julio A Gutierrez; Maria Freni; Joseph A Odin; Carmen M Stanca; Sukma Merati; Thomas D Schiano; Andrea D Branch; Swan N Thung
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Publication Detail:
Type:  Journal Article     Date:  2009-01-12
Journal Detail:
Title:  Hepatology research : the official journal of the Japan Society of Hepatology     Volume:  39     ISSN:  1386-6346     ISO Abbreviation:  Hepatol. Res.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-16     Completed Date:  2011-07-14     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9711801     Medline TA:  Hepatol Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  577-84     Citation Subset:  -    
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Grant Support
L30 EY016156-01/EY/NEI NIH HHS; R01 DK066939/DK/NIDDK NIH HHS; R01 DK066939-05S1/DK/NIDDK NIH HHS

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