A higher magnification of the centrilobular region of the backtable
biopsy shown in previous figure
ascertains the integrity of the hepatocytes.
Note also the presence of lipofuschin pigment, which is most obvious
in the hepatocytes immediately subjacent to the terminal hepatic venule.
Not infrequently, a pathologist may be requested by an inexperienced surgeon
to examine a donor liver by frozen section because it has an "odd color",
which is usually grey-brown.
In this circumstance it is important for the pathologist to distinguish
bile(cholestasis), from lipofuschin or other pigment, which could influence
the decision to use the donor organ for transplantation. In such cases, it
is wise to know the donor's age and the serum bilirubin at the time of
harvesting. Morphologically, bile is less granular than lipofuschin.
In addition, it is wise to look for bile plugs in the canaliculi located
between hepatocytes, before making the diagnosis of cholestasis.