Showing papers by "Dale C. Snover published in 1987"

Liver allograft rejection. An analysis of the use of biopsy in determining outcome of rejection.

Abstract: Two-hundred-seventy biopsy specimens from 47 patients undergoing liver transplants at the University of Minnesota were analyzed to determine if histological features could predict the eventual outcome of rejection episodes. Thirty-six patients (76.6%) rejected the transplant. Of these, five either suffered acute liver failure due to rejection (two cases) or developed chronic rejection (three cases). Features of significance in predicting such a bad outcome were arteritis, bile duct paucity, or simultaneous hepatocellular ballooning and hepatocellular dropout and necrosis. Other features, such as type and intensity of infiltrate, degree of bile duct damage, or simple presence of hepatocellular necrosis, were not predictive of outcome. Our conclusion is that biopsy is useful in predicting outcome. Since many of the histologic findings of predictive value were not present in initial pretreatment biopsy specimens, follow-up biopsies of patients being treated for rejection are recommended to assess efficacy of therapy.

Increased expression of class I major histocompatibility complex antigens on hepatocytes in rejecting human liver allografts.

Abstract: L'analyse de 43 biopsies chez 22 receveurs, 4 biopsies de foie normal et 8 biopsies dans des affections hepatiques differentes. Observation d'une expression accrue des antigenes de classe I du complexe majeur d'histocompatibilite au cours du rejet aigu. Diminution de cette expression apres resolution de l'episode de rejet

Cytomegalovirus infection of the liver in transplant recipients.

Abstract: Thirty-two transplant recipients with cytomegalovirus (CMV) infection documented by positive culture of blood and/or organs other than the liver were evaluated for hepatic involvement. Thirteen of the 32 (41%) had evidence of hepatic involvement with CMV. Inclusions alone were present in three patients; liver cultures alone were positive for CMV in three; and both were present in seven. Although the presence of CMV inclusions was the only histological feature that clearly separated the groups with and without hepatic involvement, two items helpful in finding inclusions were lobular aggregates of polymorphonuclear cells and portal karyorrhexic debris. The presence of liver involvement had a significant correlation with multiple organ infection, indicating it is a good marker of widely disseminated disease. This study indicates that liver histology and culture are useful and complementary methods for documentation of hepatic involvement (hence, tissue invasion) in immunocompromised patients with CMV infection.

Abdominal sonography after hepatic transplantation: results in 36 patients

Abstract: Hepatic transplantation was performed in 46 patients over a 2-year period at the University of Minnesota. Thirty-six of these patients subsequently underwent 166 sonographic examinations of the upper abdomen. Forty-three examinations were performed within 2 weeks of transplantation, 47 between 2 and 8 weeks after transplantation, and 76 more than 8 weeks after transplantation. The sonograms were reviewed retrospectively and correlated with the available clinical and histopathologic data. Diffuse, nonspecific parenchymal abnormalities were seen in 27 patients. Focal regions of parenchymal abnormality seen in four patients were associated with abscess and infarction. Moderate to severe biliary dilatation was seen in seven patients with biliary obstruction diagnosed by percutaneous or T-tube cholangiography. Obstruction was seen most commonly in children who had undergone cholecystojejunostomy biliary reconstruction, and it required radiologic or surgical intervention. Routine sonographic assessment of the u...