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. 1969 Feb;128(2):327-39.

Clinical and pathologic observations after orthotopic transplantation of the human liver

T E Starzl, K A Porter, L Brettschneider, I Penn, P Bell, C W Putnam, R L McGuire

Clinical and pathologic observations after orthotopic transplantation of the human liver

T E Starzl et al. Surg Gynecol Obstet. 1969 Feb.
No abstract available

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Figures

Fig. 1
Fig. 1
Roentgenograms of the chest of a 19 month old child, who was treated with orthotopic liver transplantation for the indication of hepatoma. a, Preoperative study. Elevation of the right side of the diaphragm was caused by the marked hepatomegaly. b, Multiple pulmonary metastases as seen seven months after transplantation. Evidence of the spread had first been detected in the third postoperative month. c, Massive pulmonary metastases at one year. The child died of carcinonatosis 400 days after trasplantation.
Fig. 2
Fig. 2
Liver homograft obtained at autopsy, 400 days after transplantation. Note the two large metastatic nodules in the superior portion of the right lobe.
Fig. 3
Fig. 3
Roentgenograms of the chest of a 42 year old man who received an orthotopic liver transplantation on 14 April 1968. The indication for operation was hepatoma. a, Ten days postoperatively. b, Eighty days postoperatively. A tiny nodule, arrow, was detected in the right lung. c, Two months later, the nodule had perceptibly increased in size and other fine metastatic deposits appeared in both lungs.
Fig. 4
Fig. 4
Postmortem aortogram obtained 400 days after orthotopic liver transplantation. Note that no hepatic arterial supply is demonstrable. C. AXIS, celiac axis: LGA, left gastric artery; LPA, left phrenic artery; RPA, right phrenic artery; RRA, right renal artery; SA, splenic artery; SMA, superior mesenteric artery.
Fig. 5
Fig. 5
Course of a two year old child who received the liver of a 33 month old cadaveric donor. Liver function was excellent and stable for many postoperative months. About two months after horse antilymphocyte globulin, ALG, was discontinued, an indolent late rejection began. The changes in serum enzymes were partially reversed by intensification of immunosuppressive therapy, but the bilirubin has remained high. SGOT, serum glutamic oxalacetic transaminase; SGPT, serum glutamic pyruvic transaminase; I.U., international unit.
Fig. 6
Fig. 6
Course of a 42 year old man who received a liver homograft six months previously. There was a vigorous early rejection, but this reversed promptly without any changes in therapy. Liver function has been normal for many months. Therapy with horse antilymphocyte globulin, ALG, has never been discontinued. Unfortunately, pulmonary metastases from the hepatoma have developed. (Fig. 3). SGOT, serum glutamic oxalacetic transaminase; SGPT, serum glutamic pyruvic transarninase; I.U., international unit.
Fig. 7
Fig. 7
Operative cholangiogram of a 16 year old girl obtained ten weeks after orthotopic liver transplantation for the indication of hepatoma. Re-exploration was carried out because of persistent jaundice. The dye was injected after inserting a Foley catheter through the cholecystoduodenostomy into the gallbladder. Note that the biliary drainage from the homograft is not obstructed but that the fine ramifications of the intrahepatic ductal system are not seen. CBD, common bile duct; CD, cystic duct; CHD, common hepatic duct; GB, gallbladder.
Fig. 8
Fig. 8
Course of a 23 month old child who received two orthotopic liver homografts. When the first one rejected, the patient became febrile and progressively more toxic. The organ was eventually removed and replaced with a second liver. Although a difficult rejection is still in progress, affecting the final homograft, the patient is in good condition. SGOT, serum gIutamic oxalacetic transaminase; SGPT, serum glutamic pyruvic transaminase; I.U., international unit.
Fig. 9
Fig. 9
Appearance of the rejected liver which was removed (Fig. 8) and replaced with a second homograft. Note the huge size and uneven color of the organ.
Fig. 10
Fig. 10
Hepatic homograft removed 66 days after transplantation. Uncontrollable rejection followed early withdrawal of antilymphocyte globulin. Large numbers of infiltrating mononuclear cells with basophilic cytoplasm lie in a portal tract. Hematoxylin and eosin, ×417.
Fig. 11
Fig. 11
Same liver graft as seen in Figure 10. In the portal tract, a branch of the hepatic artery is greatly narrowed by large intimal cells with foamy cytoplasm. The internal elastic lamina of the vessel is indicated by the arrow. Elastic stain, ×208.
Fig. 12
Fig. 12
Same liver graft as seen in Figures 10 and 11 shows a branch of the hepatic artery in a portal tract. The vessel is completely occluded by intimal thickening, and the internal elastic lamina is ruptured. Elastic stain, ×208.
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References

    1. BERMAN C. Primary carcinoma of the liver. Bull. N. Y. Acad. Med. 1959;35:275. - PMC - PubMed
    1. BIRTCH AG, MOORE FD. Personal communication. Aug 22, 1968.
    1. BURNET FM. The new approach to immunology. New Eng. J. Med. 1961;264:24. - PubMed
    1. GROTH CG, PECHET L, STARZL TE. Coagulation during and after orthotopic transplantation of the human liver. Arch. Surg. 1968 in press. - PMC - PubMed
    1. LOWER RR, DONG E, SHUMWAY NE. Long-term survival of cardiac homografts. Surgery. 1965;58:110. - PubMed

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