Flechtenmacher Christa, Schirmacher Peter, Schemmer Peter
Department of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany,
Langenbecks Arch Surg. 2015 Jul;400(5):551-7. doi: 10.1007/s00423-015-1298-7. Epub 2015 Mar 26.
Due to a tremendous organ shortage, livers from donors with extended criteria are increasingly considered for transplantation. Pathologists are more and more requested to evaluate these livers histopathologically using frozen sections at high urgency for acceptability.
This article reviews the current knowledge on pre-transplant histology in liver transplantation. Prerequisites and conditions for proper pre-transplant evaluation of donor liver tissue are discussed as well as frozen section evaluation and reporting. Data sources include the relevant medical literature, web sites specialized in organ transplantation, and the authors' experiences in liver transplant centers.
Pre-transplant histopathological evaluation is a time-effective, accurate, and reliable tool to assess liver quality from candidate deceased donors. Pre-transplant biopsies are of value in the selection of donor livers for transplantation, especially in case of extended criteria donors, and should be performed more frequently in order to avoid unnecessary loss of organs suitable for transplantation and transplantation of inappropriate organs. Correlation of histopathological findings with clinical conditions is essential and requires excellent communication between pathologists, surgeons, and the other members of the transplant team.
由于器官严重短缺，越来越多地考虑使用边缘供肝进行肝移植。病理学家越来越多地被要求在高度紧急的情况下，通过冷冻切片对这些肝脏进行组织病理学评估，以确定其是否适合移植。
本文综述了肝移植术前组织学的现有知识。讨论了对供肝组织进行适当的术前评估的前提条件和情况，以及冷冻切片评估和报告。数据来源包括相关医学文献、专门的器官移植网站以及作者在肝移植中心的经验。
术前组织病理学评估是一种评估候选脑死亡供肝质量的高效、准确且可靠的工具。术前活检对于选择供肝进行移植具有重要价值，尤其是对于边缘供肝，应更频繁地进行，以避免适合移植的器官不必要的丢失以及不适合器官的移植。组织病理学结果与临床情况的相关性至关重要，这需要病理学家、外科医生和移植团队的其他成员之间进行良好的沟通。
