Fine needle aspiration biopsy inflammatory profile. An evaluation in a liver transplant patient

Summary

We have studied a liver transplant by frequent fine needle aspiration biopsies (FNAB) and transplantation aspiration cytology. The patient was a 21-year-old woman with chronic active hepatitis, she died 80 days after the transplantation in sepsis and probably of prolonged graft rejection. Three episodes of inflammation were recorded during the postoperative course. These three episodes all coincided with clinical evidence of transplant failure. The first episode of inflammation consisted mainly of mononuclear phagocytes and was devoid of any lymphoid blastogenic component. Concomitantly both clinical and cytological evidence of cholestasis were present. The second and third episodes were typical blast dominated ‘rejections’. In addition, deposits of Cyclosporin A (CyA) were observed by direct immunofluorescence in the liver FNAB. The deposits correlated roughly to the level of CyA administration but not necessarily to the blood level of CyA. We conclude that FNAB of a liver transplant is a safe procedure that can be performed repeatedly without danger to the graft or to the recipient. It seems to be possible to record inflammatory episodes of ‘rejection’ from these cytological specimens.