Skip to main content
SpringerLink
Log in

Pathologie der transplantierten Leber

  • Chapter
Pathologie der Leber und Gallenwege

Part of the book series: Spezielle pathologische Anatomie ((SPEZIELLE,volume 10))

  • 123 Accesses

Zusammenfassung

Die Lebertransplantation ist heute eine etablierte Methode zur Behandlung von Lebererkrankungen im Endstadium (Übersicht bei Calne 1987). Seit der ersten orthotopen Lebertransplantation 1963 durch T.E. Starzl wurden bis zum Jahre 1992 in den USA und in Westeuropa über 20 000 Transplantationen mit (nach 1988) einer Überlebensrate der Patienten von ca. 62% durchgeführt (s. Pimstone et al. 1990; Otte 1991; Starzl et al. 1991; Bismuth 1994a, b; Zetterman u. Mc Cashland 1995). Dem steigenden Bedarf an Transplantationen steht aber die beschränkte Verfügbarkeit von Spenderorganen gegenüber, die zu einer Verlängerung der Wartezeit für Transplantatsempfänger führt. Notwendig sind daher die Entwicklung neuer Behandlungsmethoden (Transplantation von Organteilen, Organersatz), aber auch eine exakte (und damit auch restriktive) Indikationsstellung zur, und Planung der, Transplantation. Nach wie vor ist die Wahl des Transplantationszeitpunktes ein schwieriges Problem. Die Lebertransplantation sollte spät genug erfolgen, um eine spontane Besserung ausschließen zu können, und früh genug, um dem Eingriff eine reelle Erfolgschance und dem Patienten möglichst hohe Lebensqualität zu sichern (s. Starzl et al. 1991; Broelsch 1994; Jamieson 1994).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Adams DH (1995) Adhesion molecules and liver transplantation: new strategies for therapeutic intervention. J Hepatol 23:225–231

    Article  PubMed  CAS  Google Scholar 

  • Adams DH, Neuberger JM (1992) Treatment of acute rejection. Sem Liver Dis 12:80–88

    Article  CAS  Google Scholar 

  • Ascher NL, Lake JR, Emond J, Roberts J (1994) Liver transplantation for hepatitis C virus-related cirrhosis. Hepatology 20:24S–27S

    PubMed  CAS  Google Scholar 

  • Balan V, Batts KP, Porayko MK, Krom RAF, Ludwig J, Wiesner RH (1993) Histological evidence for recurrence of primary biliary cirrhosis after liver transplantation. Hepatology 18: 1392–1398

    Article  PubMed  CAS  Google Scholar 

  • Belzer FO, Southard JH (1991) Organ preservation. In: Sabiston DC (ed) Textbook of surgery. The biological basis of modern surgical practice, 14th edn. WB Saunders, London Philadelphia Toronto Montreal Sydney Tokyo, pp 418–423

    Google Scholar 

  • Benhamou JP (1994) Indications for liver transplantation in primary biliary cirrhosis. Hepatology 20:11S–13S

    PubMed  CAS  Google Scholar 

  • Bismuth H (1994a) The need for a consensus agreement on indications of liver transplantation. Hepatology 20:1S–2S

    PubMed  CAS  Google Scholar 

  • Bismuth H (1994b) Consensus statement on indications for liver transplantation: Paris, June 22-23. Hepatology 20:63S–68S

    Article  Google Scholar 

  • Bloom S, Fleming K, Chapman R, Neuberger J, Hubscher S (1994) Inappropriate expression of blood group antigens in hepatic allografts. Hepatology 19:876–881

    Article  PubMed  CAS  Google Scholar 

  • Broelsch CE (1994) Indikation zur Transplantation bei benignen Lebererkrankungen — die Wahl des Zeitpunktes. Chir Gastroenterol 10:386–391

    Article  Google Scholar 

  • Broelsch CE, Burdelski M, Rogiers X, Gundlach M, Knoefel WT, Langwieler T (1994) Living donor for liver transplantation. Hepatology 20:49S–55S

    PubMed  CAS  Google Scholar 

  • Burdelski M, Latta A, Drews D, Rogiers X, Malago M, Broelsch CE (1994) Innovative chirurgische Techniken für die Lebertransplantation im Kindesalter. Chir Gastroenterol 10:443–446

    Article  Google Scholar 

  • Calne R (ed) (1987) Liver transplantation. The Cambridge-King’s College Hospital Experience, 2edn, Grune & Stratton, Orlando New York San Diego London San Francisco Tokyo Sydney Toronto

    Google Scholar 

  • Calne R (1994) Contraindication to liver transplantation. Hepatology 20:3S–4S

    PubMed  CAS  Google Scholar 

  • Chazouillères O, Calmus Y, Vaubourdolle M, Ballet F (1993) Preservation-induced liver injury. Clinical aspects, mechanisms and therapeutic approaches. J Hepatol 18:123–134

    Article  PubMed  Google Scholar 

  • Colina F, Mollejo M, Moreno E, Albert N, Garcia I, Gomez-Sanz R, Castellano G (1991) Effectiveness of histopathological diagnosis in dysfunction of hepatic transplantation. Arch Pathol Lab Med 115:998–1005

    PubMed  CAS  Google Scholar 

  • Davies SE, Portmann BC, O’Grady JG, Aldis PM, Chaggar K, Alexander GJM et al. (1991) Hepatic histological findings after transplantation for chronic hepatitis B virus infection, including a unique pattern of fibrosing cholestatic hepatitis. Hepatology 13:150–157

    Article  PubMed  CAS  Google Scholar 

  • Demetris AJ, Murase N, Nakamura K, Iwaki Y, Yagihashi A, Validiva L et al. (1992) Immunopathology of antibodies as effectors of orthotopic liver allograft rejection. Sem Liver Dis 12:51–59

    Article  CAS  Google Scholar 

  • Demetris AJ, Batts KP, Dhillon AP, Ferrell L, Fung J, Geller SA et al. (1997) Banff schema for grading liver allograft rejection: An international concensus document. Hepatology 25:658–663

    Article  Google Scholar 

  • Dominguez EA (1995) Long-term infectious complications of liver transplantation. Sem Liver Dis 15:133–138

    Article  CAS  Google Scholar 

  • European FK 506 Multicentre Liver Study Group (1994) Randomized trial comparing tacrolimus (FK 506) and cyclosporin in prevention of liver allograft rejection. The Lancet 344:423–428

    Article  Google Scholar 

  • Goffey MJ, Boyd JC, Traweek ST, Ali MA, Rezeig M, Caldwell SH et al. (1997) Predictive value of intraoperative biopsies and liver function tests for preservation injury in orthotopic liver transplantation. Hepatology 25:184–189

    Article  Google Scholar 

  • Goldstein NS, Hart J, Lewin KJ (1991) Diffuse hepatocyte ballooning in liver biopsies from orthotopic liver transplant patients. Histopathol 18:331–338

    Article  CAS  Google Scholar 

  • Gomez R, Colina F, Moreno E, Gonzalez I, Loinaz C, Garcia I et al. (1994) Etiopathogenesis and prognosis of centrilobular necrosis in hepatic grafts. J Hepatol 21:441–446

    Article  PubMed  CAS  Google Scholar 

  • Gonzalez FX, Rimola A, Grande L, Antolin M, Garcia-Valdecasas JC, Fuster J et al. (1994) Predictive factors of early postoperative graft function in human liver transplantation. Hepatology 20:565–573

    PubMed  CAS  Google Scholar 

  • Gubernatis G (1994) Spenderkriterien und Konservierung — die Qualitat der Spenderleber. Chir Gastroenterol 10:417–421

    Article  Google Scholar 

  • Gupta SD, Hudson M, Burroughs AK, Morris R, Rolles K, Amlot P et al. (1995) Grading of cellular rejection after orthotopic liver transplantation. Hepatology 21:46–57

    Article  Google Scholar 

  • Hanto DW, Snover DC, Sibley RK, Noreen HJ, Gajl-Pezalska KJ, Najarian JS et al. (1987) Hyperacute rejection of a human orthotopic liver allograft in presensitized recipient. Clin Transpl 1:304–310

    Google Scholar 

  • Harrison J, McMaster P (1994) The role of orthotopic liver transplantation in the management of sclerosing cholangitis. Hepatology 20:14S–19S

    Article  PubMed  CAS  Google Scholar 

  • Harrison RF, Davies MH, Neuberger JM, Hubscher SG (1994) Fibrous and obliterative cholangitis in liver allografts: evidence of recurrent primary sclerosing cholangitis? Hepatology 20:356–361

    Article  PubMed  CAS  Google Scholar 

  • Hart J, Busuttil RW, Lewin KJ (1990) Disease recurrence following liver transplantation. Ann J Surg Pathol 14:79–91

    Google Scholar 

  • Heffron TG (1995) Liver related liver transplantation. Sem Liver Dis 15:165–172

    Article  CAS  Google Scholar 

  • Hertzler GL, Millikan WJ (1991) The surgical pathologist’s role in liver transplantation. Arch Pathol Lab Med 115:273–282

    PubMed  CAS  Google Scholar 

  • Hubscher SG, Elias E, Buckels JAC, Mayer AD, McMaster P, Neuberger JM (1993) Primary biliary cirrhosis. Histological evidence of disease recurrence after liver transplantation. J Hepatol 18:173–184

    Article  PubMed  CAS  Google Scholar 

  • Ildstad ST, Simmons RL, Najarian JS (1991) Principles of immunosuppression. In: Sabiston DC (ed) Textbook of Surgery. The biological basis of modern surgical practice, 14th edn. WB Saunders, London Philadelphia Toronto Montreal Sydney Tokyo, pp 401–417

    Google Scholar 

  • International Working Party (1995) Terminology for hepatic allograft rejection. Hepatology 22:648–654

    Google Scholar 

  • Jamieson NV (1994) Liver transplantation — State of the art. Acta Chir Aust 26:19–22

    Article  Google Scholar 

  • Knoefel WT, Frilling A, Rogiers X, Broelsch CE (1994) Lebertransplantation bei primaren und sekundaren Lebertumoren. Chir Gastroenterol 10:399–405

    Article  Google Scholar 

  • Krom RAF (1994) Liver transplantation and alcohol: Who should get transplants. Hepatology 20:28S–32S

    PubMed  CAS  Google Scholar 

  • Kuhlencordt R, Kjer S, Rogiers X, Broelsch CE (1994) Lebensqualitat und Transplantationsnachsorge. Chir Gastroenterol 10:440–442

    Article  Google Scholar 

  • Lake JR, Roberts JP, Ascher NL (1992) Maintenance immunosuppression after liver transplantation. Sem Liver Dis 12:73–79

    Article  CAS  Google Scholar 

  • Langrehr JM, Lohmann R, Kaisers U, Lemmens HP, Jonas S, Platz KP et al. (1994) Immunosuppressive Therapie nach Lebertransplantation. Chir Gastroenterol 10:427–432

    Article  Google Scholar 

  • Langvehr JM, Knoop M, Lohmann R, Wedell A, Kaisers V, Berg T et al. (1994) Indikation und Ergebnisse der Lebertransplantation bei posthepatitischer Zirrhose. Chir Gastroenterol 10:378–383

    Article  Google Scholar 

  • Liu G, Butany J, Wanless IR, Cameron R, Greig P, Levy G (1993) The vascular pathology of human hepatic allografts. Hum Pathol 24:182–188

    Article  PubMed  CAS  Google Scholar 

  • Ludwig J (1992) Terminology of hepatic allograft rejection (glossary). Sem Liver Dis 12:89–92

    Article  CAS  Google Scholar 

  • Ludwig J, Batts KP (1994) Transplantation pathology. Including liver injury in graft versus host disease and in recipients of renal and other allografts. In: Mac Sween RNM, Anthony PP, Scheuer PJ, Burt AD, Portmann BC (eds) Pathology of the liver, 3. edn. Churchill Livingstone, Edinburgh London Madrid Melbourne New York Tokyo, pp 765–786

    Google Scholar 

  • Ludwig J et al. (1994) Terminology of chronic hepatitis, hepatic allograft rejection and nodular lesions of the liver: Summary of recommendations developed by an international working party, supported by the World Congresses of Gastroenterology Los Angeles, 1994. Am J Gastroenterol 89:5177–5181

    Google Scholar 

  • Manns MP, Krüger M (1994) Lebertransplantation als praktizierte Gentherapie. Internist 35:330–336

    PubMed  CAS  Google Scholar 

  • Matsumoto Y, McCaughan GW, Painter DM, Bishop GA (1993) Evidence that portal tract microvascular destruction precedes bile duct loss in human liver allograft rejections. Transplantation 56:69–75

    Article  PubMed  CAS  Google Scholar 

  • Michel J, Sue B, Montepeyroux F, Hachemanne S, Blanc P, Domergue J et al. (1997) Liver resection or transplantation for hepatocellular carcinoma? Retrospective analysis of 215 patients with cirrhosis. J Hepatol 26:1274–1280

    Article  PubMed  CAS  Google Scholar 

  • Mor E, Solomon H, Gibbs JF, Holman MJ, Goldstein RM, Husberg BS et al. (1992) Acute cellular rejection following liver transplantation. Clinical pathologic features and effect on outcome. Seminars Liver Dis 12:28–40

    Article  CAS  Google Scholar 

  • Moreno Gonzalez E, Loinaz C, Garcia I, Lumbreras C, Gomez R, Moraleda G et al. (1993) Liver transplantation in chronic viral B and C hepatitis. J Hepatol 17 (Suppl):S116–S122

    Article  Google Scholar 

  • Neuberger J (1995) Liver allograft rejection — current concepts on diagnosis and treatment. J Hepatol 23 (Suppl):54–6

    PubMed  Google Scholar 

  • Ng IOI, Burroughs AK, Rolles K, Belli L, Scheuer P (1991) Hepatocellular ballooning after liver transplantation: a light and electron microscopic correlation. Histopathol 18:323–330

    Article  CAS  Google Scholar 

  • Otte JB (1991) Recent developments in liver transplantation. Lessons from a 5-year experience. J Hepatol 12:386–393

    Article  PubMed  CAS  Google Scholar 

  • Otte JB, De Ville, DeGoyet J, Reding R, Hausleithner V, Sokal E (1994) Sequential treatment of biliary atresia with Kasai portoenterostomy and liver transplantation: A review. Hepatology 20:41S–48S

    PubMed  CAS  Google Scholar 

  • Otto G (1994) Bedeutung des Perfusionsschadens für die Transplantatprognose. Chir Gastroenterol 10:422–426

    Article  Google Scholar 

  • Pichlmayr R, Weimann A, Ringe B (1994) Indications for liver transplantation in hepatobiliary malignancy. Hepatology 20:33S–40S

    PubMed  CAS  Google Scholar 

  • Pimstone NR, Goldstein LI, Ward R, Ruebner BH (1990) Liver transplantation. In: Zakim D, Boyer TD (eds) Hepatology. A textbook of liver disease, 2 edn. WB Saunders, London Philadelphia Toronto Montreal Sydney Tokyo, pp 1459–1475

    Google Scholar 

  • Pons JA (1995) Role of liver transplantation in viral hepatitis. J Hepatol 22 (Suppl):146–153

    PubMed  CAS  Google Scholar 

  • Porayko MK, Kondo M, Steers JL (1995) Liver transplantation: Late complications of the biliary tract and their management. Sem Liver Dis 15:139–155

    Article  CAS  Google Scholar 

  • Rauen V, Viebahn R, Lauchart W, Groot H de (1994) The potential role of reactive oxygen species in liver ischemia/reperfusion injury following liver surgery. Hepto-Gastroenterol 41:333–336

    CAS  Google Scholar 

  • Ringe B, Canelo R (1994) Akutes Leberversagen und Vorgehen bei Notfallindikationen. Chir Gastroenterol 10:406–410

    Article  Google Scholar 

  • Rogiers X, Sterneck M, Malago M, Schulte am Esch J, Fischer L, Broelsch CE (1994) Diagnose und Therapie der akuten und chronischen Abstofiungsreaktion der transplantierten Leber bei Standardimmunsuppression. Chir Gastroenterol 10:343–438

    Article  Google Scholar 

  • Sanchez-Urdazpal L, Sterioff S, Janes C, Schwerman L, Rosen C, Krom RAF (1991) Increased bile duct complications in ABO incompatible liver transplant recipients. Transplant Proc 23:1440–1441

    PubMed  CAS  Google Scholar 

  • Sanfilippo F, Amos DB (1991) Mechanisms and characteristics of allograft rejection. In: Sabiston DC (ed) Textbook of Surgery. The biological basis of modern surgical practice, 14th edn. WB Saunders, London Philadelphia Toronto Montreal Sydney Tokyo, pp 357–374

    Google Scholar 

  • Scheuer PJ, Lefkowitch JH (1994) Liver biopsy interpretation, 5th edn. WB Saunders, London Philadelphia Toronto Montreal Sydney Tokyo

    Google Scholar 

  • Sebagh M, Farges O, Kalil A, Sammel D, Bismuth H, Reynes M (1995) Sclerosing cholangitis following human orthotopic liver transplantation. Am J Surg Pathol 19:81–90

    Article  PubMed  CAS  Google Scholar 

  • Shah G, Demetris A, Gavaler J et al. (1992) Incidence, prevalence, and clinical course of hepatitis C following liver transplantation. Gastroenterol 103:323–329

    CAS  Google Scholar 

  • Sherman D, Williams R (1995) Liver transplantation for alcoholic liver disease. J Hepatol 23:474–479

    Article  PubMed  CAS  Google Scholar 

  • Snover DC (1989) Problems in the interpretation of liver biopsies after liver transplantation. Am J Surg Pathol 13:31–38

    PubMed  Google Scholar 

  • Snover DC, Freese DK, Sharp HC, Bloomer JR, Najarian JA, Ascher N (1987) Liver allograft rejection: an analysis of the use of biopsy in determining outcome of rejection. Am J Surg Pathol 11:1–10

    Article  PubMed  CAS  Google Scholar 

  • Starzl TE, Gordon RD, Tzakis AG, Todo S (1991) Liver transplantation. In: Sabiston DC (ed) Textbook of Surgery. The biological basis of modern surgical practice, 14th edn. WB Saunders, London Philadelphia Toronto Montreal Sydney Tokyo, pp 423–433

    Google Scholar 

  • Steinhoff G, Behrend M, Schraden B, Pichlmayer R (1993) Intercellular immune adhesion molecules in human liver transplants: overview on expression patterns of leukocyte receptor and ligand molecules. Hepatology 18:440–453

    Article  PubMed  CAS  Google Scholar 

  • Stephens J, Goldstein R, Crippin J, Husberg B, Holman M, Gonwa TA et al. (1993) Effects of orthotopic liver transplantation on inflammatory bowel disease in primary sclerosing cholangitis patients. Transplant Proc 25:1122–1123

    PubMed  CAS  Google Scholar 

  • Van Hoek B, Wiesner RH, Krom RAF, Ludwig J, Moore SB (1992) Severe ductopenic rejection following liver transplantation: incidence, time of onset, risk factors, treatment, and outcome. Sem Liver Dis 12:41–50

    Article  Google Scholar 

  • Van Hoek B, Ringers J, Kroes ACM, Van Krieken JHJM, Van Schelven WD, Masclee AAM et al. (1995) Temporary heterotopic auxiliary liver transplantation for fulminant hepatitis B. J Hepatol 23:109–118

    Article  PubMed  Google Scholar 

  • Van Thiel DH, Wright HI, Faginoli S (1994) Liver transplantation for hepatitis B virus — associated cirrhosis: A progress report. Hepatology 20:20S–23S

    Article  PubMed  Google Scholar 

  • Viebahn R, Lauchart W (1994) Indikation zur Lebertransplantation bei Alkoholzirrhose. Chir Gastroenterol 10:392–396

    Article  Google Scholar 

  • Vierling JM (1992) Immunologic mechanisms of hepatic allograft rejection. Sem Liver Dis 12:16–27

    Article  CAS  Google Scholar 

  • Whitington PF, Alonso EM, Piper JB (1994) Pediatric liver transplantation. Sem Liver Dis 14:303–317

    Article  CAS  Google Scholar 

  • Wiesner RH, Ludwig J, Van Hoek B, Krom RAF (1991) Current concepts in cell-mediated allograft rejection leading to ductopenia and liver failure. Hepatology 14:721–729

    Article  PubMed  CAS  Google Scholar 

  • Williams JN, Foster PF, Sankary HN (1992) Role of liver allograft biopsy in patient management. Sem Liver Dis 12:60–72

    Article  CAS  Google Scholar 

  • Williams R, Wendon J (1994) Indications for orthotopic liver transplantation in fulminant liver failure. Hepatology 20:5S–10S

    Google Scholar 

  • Zetterman RK, McCashland TM (1995) Long:term follow-up of the orthotopic liver transplantation patient. Sem Liver Dis 15:173–180

    Article  CAS  Google Scholar 

  • Zhao D, Zimmermann A, Wheatley AM (1993) Morphometry of the livers after liver transplantation in the rat: significance of an intact arterial supply. Hepatology 17:310–317

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. H. Denk
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Denk, H. (2000). Pathologie der transplantierten Leber. In: Pathologie der Leber und Gallenwege. Spezielle pathologische Anatomie, vol 10. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57036-0_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-57036-0_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-65511-4

  • Online ISBN: 978-3-642-57036-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation