Liver Transplantation - 18

<html>  <HEAD><title>Liver Transplant - Case 18</title></HEAD> <body bgcolor=#ffffff link="darkblue" vlink="006666"> <IMG SRC="/tpis/icons/purpball.gif"> <i>Contributed by Anthony J. Demetris, M.D.</A></i> <HR> <b>PATIENT HISTORY:</b> The patient is a 71-year-old woman who underwent liver transplantation in 1989 and recently has elevated liver function tests. The original concern of areas of confluent necrosis being viral in etiology was raised because of occasional subsmudged cells. The current interpretation in light of the patient's profound cholestasis is that these represent bile infarcts and possibly biliary obstruction. This impression was supported by subsequent discussion with the clinicians who indicate that early on in the patient's course, she appeared with hepatic artery thrombosis and developed biliary strictures of apparent ischemic origin. The presence of bile duct injury at the same time raises the possibility of a component of chronic rejection. Review of outside material. <hr> <A HREF="GH00044.html">GROSS DESCRIPTION</a><P> <A HREF="/tpis/images/H00044a.jpg"><IMG SRC="/tpis/images/tnails/H00044a.jpg" width=133 height=100></a> <A HREF="/tpis/images/H00044b.jpg"><IMG SRC="/tpis/images/tnails/H00044b.jpg" width=133 height=100></a> <A HREF="/tpis/images/H00044c.jpg"><IMG SRC="/tpis/images/tnails/H00044c.jpg" width=133 height=100></a> <A HREF="/tpis/images/H00044d.jpg"><IMG SRC="/tpis/images/tnails/H00044d.jpg" width=133 height=100></a> <A HREF="/tpis/images/H00044e.jpg"><IMG SRC="/tpis/images/tnails/H00044e.jpg" width=133 height=100></a> <A HREF="/tpis/images/H00044f.jpg"><IMG SRC="/tpis/images/tnails/H00044f.jpg" width=133 height=100></a> <A HREF="/tpis/images/H00044g.jpg"><IMG SRC="/tpis/images/tnails/H00044g.jpg" width=133 height=100></a> <A HREF="/tpis/images/H00044h.jpg"><IMG SRC="/tpis/images/tnails/H00044h.jpg" width=133 height=100></a> <P> <A HREF="MH00044.html">MICROSCOPIC DESCRIPTION</a><P> <A HREF="XH00044.html">FINAL DIAGNOSIS</a><P>  <hr> <font size=3> Please mail comments, corrections or suggestions to the <a href="mailto:harperth@upmc.edu"> <i>TPIS administration</i></a> at the UPMC.<p> This page and its contents are Copyright © 1996, 1997 <A HREF="http://www.upmc.com/Pages/default.aspx">University of Pittsburgh</a>. All rights reserved. Unauthorized redistribution prohibited.<p> </body> </html>