Cima L, Riva G, D'Errico A, Casartelli-Liviero M, Capelli P, Tomezzoli A, Montin U, Carraro A, Scarpa A, Ghimenton C, Colombari R, Brunelli M, Eccher A
Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy.
Department of Specialized, Experimental and Diagnostic Medicine, S. Orsola-Malpighi University Hospital of Bologna, Bologna, Italy.
Transplant Proc. 2017 May;49(4):667-670. doi: 10.1016/j.transproceed.2017.02.024.
Assessment of potential liver allograft donors with frozen sections has clinical relevant consequences for the transplant recipient. Several clinical risk factors have been identified that increase the risk of transplantation failure and it is critical for the pathologist to become familiar with the histologic criteria for donor liver suitability. In this setting an accurate and reliable assessment of fibrosis is crucial. We sought to report the value of the rapid chromotrope aniline blue stain (CAB) in a transplantation clinical work-flow for scoring liver fibrosis.
Twenty consecutive intraoperative donor liver biopsy specimens were evaluated by a pathologist at the Transplant Pathology Board Room, AOUI Verona, during 24-hour on-call service. The stage of fibrosis was evaluated according to Ishak score ranging from 0 to 6 (absent to cirrhosis) using hematoxylin and eosin stain (H&E) plus rapid CAB special stain. After a 3-week washout period, only the slides stained with H&E were re-assessed for fibrosis stage by the same pathologist blinded to donor patient data.
Combination H&E-CAB staging fibrosis score was higher in 20%, lower in 10%, and the same in 70% of biopsy specimens as determined using only H&E stain alone. Rapid CAB stain takes 20 minutes longer than H&E stain alone.
CAB staining may be performed on frozen tissue from liver biopsy during a transplantation process without a significant delay in diagnosis. Combination H&E-CAB staining improves sensibility of interpretation of fibrosis.
使用冰冻切片评估潜在的肝脏移植供体对移植受者具有临床相关影响。已确定了几种增加移植失败风险的临床危险因素，病理学家熟悉供体肝脏适用性的组织学标准至关重要。在这种情况下，准确可靠地评估纤维化至关重要。我们试图报告快速变色苯胺蓝染色（CAB）在肝脏纤维化评分的移植临床工作流程中的价值。
在维罗纳AOUI移植病理会议室，一名病理学家在24小时值班服务期间对连续20例术中供体肝脏活检标本进行了评估。使用苏木精和伊红染色（H&E）加快速CAB特殊染色，根据Ishak评分（范围为0至6，从无纤维化到肝硬化）评估纤维化阶段。经过3周的洗脱期后，同一名病理学家在对供体患者数据不知情的情况下，仅对用H&E染色的玻片重新评估纤维化阶段。
与仅使用H&E染色相比，20%的活检标本中H&E-CAB联合分期纤维化评分更高，10%更低，70%相同。快速CAB染色比单独的H&E染色多耗时20分钟。
在移植过程中可对肝脏活检的冰冻组织进行CAB染色，而不会显著延迟诊断。H&E-CAB联合染色可提高纤维化判读的敏感性。
