Patonai A, Nemes B, Görög D, Kóbori L, Sótonyi P, Fehérvári I, Weszelits V, Doros A, Dallos G, Schaff Z, Perner F
Altalános Orvostudományi Kar, I. Patológia és Kísérleti Rákkutató Intézet, Semmelweis Egyetem, Budapest.
Orv Hetil. 2001 Mar 4;142(9):435-41.
A total of 81 orthotopic liver transplantations were performed on 74 patients between January 1995 and December 1999 at the Department of Transplantation and Surgery of the Semmelweis University in Budapest. Indication for transplantation was liver cirrhosis in 57 cases, 10 patients were transplanted due to fulminant liver failure, while 7 patients underwent transplantation because of liver metastasis of different semimalignant tumours. During the above period, retrospective studies on 205 pre- and posttransplantation liver biopsies, 74 explanted livers, 7 explanted liver grafts and 22 autopsy cases were performed at the First Institute of Pathology and Experimental Cancer Research of the Semmelweis University in Budapest. A number of 116 protocol biopsies (dates as zero time, 7th day, 6th month and 12th month) and 73 non-protocol biopsies (taken due to liver allograft dysfunction) were analysed. Different gradings of acute rejection--characterised by trias of portal inflammation, venous endothelitis and bile duct damage--were detected in 62 cases. Chronic rejection occurred in 7 patients, with 4 cases of vanishing bile duct syndrome and one of the case of foam cell arteriopathy, add to 2 cases of chronic rejection characterized by undetermined bile duct damage. The present study includes the evaluation of 22 autopsy cases according to liver transplantation in Hungary, with the finding that liver allograft insufficiency was the main cause of mortality. Authors conclude that pathomorphological analysis has an important role in relation to liver transplantation.
1995年1月至1999年12月期间，布达佩斯塞梅尔维斯大学移植与外科系对74例患者进行了81例原位肝移植手术。移植指征为肝硬化57例，10例因暴发性肝衰竭接受移植，7例因不同类型的半恶性肿瘤肝转移接受移植。在此期间，布达佩斯塞梅尔维斯大学第一病理与实验癌症研究所对205例移植前后的肝活检、74例切除的肝脏、7例切除的肝移植物和22例尸检病例进行了回顾性研究。分析了116例方案活检（时间点为0天、第7天、第6个月和第12个月）和73例非方案活检（因肝移植功能障碍而进行）。62例检测到不同分级的急性排斥反应，其特征为门静脉炎症、静脉内皮炎和胆管损伤三联征。7例发生慢性排斥反应，其中4例为胆管消失综合征，1例为泡沫细胞动脉病变，另外2例慢性排斥反应表现为未明确的胆管损伤。本研究包括对匈牙利22例肝移植尸检病例的评估，发现肝移植功能不全是主要死亡原因。作者得出结论，病理形态学分析在肝移植中具有重要作用。
