Taddesse-Heath L, Kovi J
Department of Pathology, Howard University Hospital, Washington, DC.
J Natl Med Assoc. 1994 Oct;86(10):779-82.
Orthotopic liver transplantation is today an accepted surgical procedure for patients with irreversible, end-stage liver disease. Between 1988 and 1993, seven patients (one patient twice) received liver grafts for end-stage liver disease at Howard University Hospital, Washington, DC. In conjunction with the transplant procedure, a total of 32 liver needle biopsy specimens were submitted to the pathology department. Almost half of all liver graft failures are attributed to acute, or in a lesser degree, to chronic rejection. The purpose of this study was to describe the ultrastructural findings in acute cellular rejection and to correlate the ultrastructure with the histology. The key ultrastructural features of acute cellular rejection were: a mixed cellular inflammatory infiltrate in the portal tract, bile duct damage by immunocytes with reduplication of the epithelial basement membrane, endotheliitis, and intramitochondrial crystalline inclusions. It was concluded that electron microscopic investigation significantly contributes to better understanding the immunopathologic mechanism underlying liver allograft rejection.
原位肝移植如今是一种被认可的针对不可逆终末期肝病患者的外科手术。1988年至1993年间，7名患者（其中1名患者接受了两次移植）在华盛顿特区的霍华德大学医院接受了肝移植以治疗终末期肝病。在移植手术过程中，总共32份肝穿刺活检标本被提交至病理科。几乎一半的肝移植失败归因于急性排斥反应，或在较小程度上归因于慢性排斥反应。本研究的目的是描述急性细胞性排斥反应的超微结构特征，并将超微结构与组织学进行关联。急性细胞性排斥反应的关键超微结构特征包括：门管区混合性细胞炎性浸润、免疫细胞对胆管的损伤伴上皮基底膜重复、内皮细胞炎以及线粒体内晶体包涵体。研究得出结论，电子显微镜检查显著有助于更好地理解肝移植排斥反应的免疫病理机制。
