Snover D C
Department of Laboratory Medicine and Pathology, University of Minnesota Hospital, Minneapolis 55455.
Am J Surg Pathol. 1989;13 Suppl 1:31-8.
As more liver transplants are performed and we realize that biopsy is the best means to diagnose rejection, the surgical pathologist has gained prominence as part of the transplant team. The surgical pathologist now plays a pivotal role in the day-to-day management of liver transplant patients. Diagnosis of rejection is a major task; however, other processes, particularly infectious ones, are also important causes of liver dysfunction that must be distinguished from rejection. Rapid and accurate diagnosis of acute rejection is possible if attention is paid to diagnostic criteria. The biopsy is also valuable to assess efficacy of therapy and provide prognostic information. The histological diagnosis of chronic rejection remains difficult, if not impossible. In all cases, and especially in the assessment of chronic rejection, close cooperation with the clinical staff is essential for proper patient management.
随着越来越多的肝移植手术开展，并且我们认识到活检是诊断排斥反应的最佳手段，外科病理学家作为移植团队的一员变得越发重要。外科病理学家如今在肝移植患者的日常管理中发挥着关键作用。诊断排斥反应是一项主要任务；然而，其他过程，尤其是感染性过程，也是导致肝功能障碍的重要原因，必须与排斥反应相区分。如果关注诊断标准，急性排斥反应的快速准确诊断是可行的。活检对于评估治疗效果和提供预后信息也很有价值。慢性排斥反应的组织学诊断即便并非不可能，也仍然很困难。在所有情况下，尤其是在评估慢性排斥反应时，与临床工作人员密切合作对于妥善管理患者至关重要。
