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. 1990 Feb;22(1):25-34.

Pathologic observations in human allograft recipients treated with FK 506

A J Demetris  1 , J J Fung, S Todo, B Banner, T Zerbe, G Sysyn, T E Starzl
Affiliations

Pathologic observations in human allograft recipients treated with FK 506

A J Demetris et al. Transplant Proc. 1990 Feb.
No abstract available

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Figures

Fig 1
Fig 1
An example of a liver rescue with early chronic rejection. (A) The pre-FK 506 biopsy showed a mild portal mononuclear infiltrate with marked bile duct distortion (arrow), and clinically, the gamma glutgamyl transpeptidase was in the 2,000 range. (B) Sixty-five days after the switch to FK 506, there was still a mild portal infiltrate, but the duct damage was less severe (arrow). The gamma glutamyl transpeptidase serum activity had decreased to the 500–600 range.
Fig 2
Fig 2
An example of a liver rescue with severe acute cellular rejection. (A) Severe acute cellular rejection 45 days posttransplant. This biopsy was taken after a steroid recycle. (B) The patient was then treated with a 10-day course of OKT3, and this biopsy was obtained at the completion of therapy. Although the portal infiltrate (pt = portal tract) has slightly decreased, there was centrilobular (arrow) dropout and portal-portal bridging and clinically, graft function deteriorated. (C) Fourteen days after the switch to FK 506, the portal infiltrate had largely subsided, but there was mild portal fibrosis (pt = portal tract). Remnants of centrilobular damage were still apparent (arrow). (D) One month later, the liver architecture was returning toward normal, including the centrilobular region (arrow) and no aberrations of liver function tests were present (pt = portal tract).
Fig 3
Fig 3
An example of portal reactive change. Although there is a mild portal infiltrate, no evidence of duct or venular endothelial damage is seen. Clinically, this change was associated with mild elevations of the canalicular enzymes that spontaneously resolved without additional therapy.
Fig 4
Fig 4
An example of mild acute cellular rejection in a primary liver recipient under FK 506 therapy. Focal bile duct damage and venous infiltration (arrows) are the characteristic features.
Fig 5
Fig 5
Severe rejection in a primary liver recipient under FK 506. (A) Six days after transplantation, a biopsy revealed changes characteristics of acute cellular rejection. (B) Two weeks later, the portal infiltrate had increased and bile duct damage was evident (arrow). (C) An inflammatory arteritis was also present in the same biopsy as shown in panel B, as was (D) marked phlebitis of the terminal hepatic venule.
Fig 6
Fig 6
Other findings in liver biopsies from patients treated with FK 506 included (A) small Kupffer cell granulomas and microabscesses (arrows), although no microorganisms could be detected, (B) mild hydropic swelling of periportal hepatocytes (arrows), and (C) sinusoidal cell hypertrophy.
See this image and copyright information in PMC

References

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    1. Ochiai T, Nakajima K, Nagata M, et al. Transplantation. 1987;44:734. - PubMed
    1. Lim SLM, Thiru S, White DJG. Transplant Proc. 1987;19(suppl 6):68. - PubMed
    1. Murase N, Todo S, Lee P-H, et al. Transplant Proc. 1987;19(suppl 6):71. - PMC - PubMed
    1. Ochiai T, Nagata M, Nakajima K, et al. Transplantation. 1987;44:729. - PubMed

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