Liver transplantation pathology

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Liver transplantation pathology is a niche within a niche. It deals with question: "Is it rejection or something else?".

Donor liver suitability

Donor livers are assessed using frozen section:


  • Microvesicular steatosis does not appear to affect graft function.[2]


Tx: more immunosuppression.


RAI (rejection activity index):[3]

  • Based on three components:
    1. Endothelial inflammation - scored 0-3.
    2. Bile duct damage - scored 0-3.
    3. Portal inflammation - scored 0-3.
  • The three components are added to give a score with a range of 0 to 9.

See also


  1. Heller, B.; Peters, S. (Jul 2011). "Assessment of liver transplant donor biopsies for steatosis using frozen section: accuracy and possible impact on transplantation.". J Clin Med Res 3 (4): 191-4. doi:10.4021/jocmr629w. PMID 22121403.
  2. Crowley, H.; Lewis, WD.; Gordon, F.; Jenkins, R.; Khettry, U. (Oct 2000). "Steatosis in donor and transplant liver biopsies.". Hum Pathol 31 (10): 1209-13. doi:10.1053/hupa.2000.18473. PMID 11070113.
  3. Höroldt BS, Burattin M, Gunson BK, et al. (July 2006). "Does the Banff rejection activity index predict outcome in patients with early acute cellular rejection following liver transplantation?". Liver Transpl. 12 (7): 1144–51. doi:10.1002/lt.20779. PMID 16799959.