The liver in XXXX : a biopsy and explant series of the histopathologic and laboratory findings with a particular focus on pre-cardiac transplant evaluation.

@entity1 @entity712 @entity82 @entity384 @entity843 @entity409 @entity1463 @entity1578 @entity299
UNASSIGNED: The pathologic liver changes in chronic @entity712 have been characterized mostly based on autopsy series and include @entity384 and @entity384 progressing to pericellular @entity82 , bridging @entity82 , and ultimately to @entity299 or @entity1463 . Liver biopsies are commonly obtained as part of the work up before heart transplantation in @entity1 with longstanding @entity712 , particularly if @entity843 , @entity409 tests or abnormal abdominal imaging are noted as part of the pre-transplant evaluation. In these cases, the liver biopsy findings may be used to further risk stratify @entity1 for isolated heart or combined heart and liver transplantation. Thus, it is important to be able to correlate the histologic changes with post-transplant outcomes. We report the pathologic and clinical findings in liver explants from six @entity1 who underwent combined heart-liver transplantation. We also report preoperative liver biopsy findings from 21 @entity1 who underwent heart transplantation without simultaneous liver transplantation. We staged the changes related to @entity384 as follows: stage 0-no @entity82 ; stage I-pericellular @entity82 ; stage II-bridging @entity82 ; and stage III-regenerative nodules. Nineteen biopsies showed @entity82 with bridging @entity82 in 13 and regenerative nodules in 6. Fifteen @entity1 were alive at 1 year post transplant. Only three @entity1 had a post-operative course that was characterized by signs and symptoms of @entity409 . Pre-transplant liver biopsies from these @entity1 all showed at least stage II @entity82 . These @entity1 survived for 3, 6, and 10 months after cardiac transplant. The presence of bridging @entity82 was not significantly associated with post-operative survival (P=0.336) or post-operative @entity1578 (P=0.257). We conclude that @entity1 with bridging @entity82 may still be considered viable candidates for isolated heart transplantation. Because the pattern of @entity82 due to passive @entity384 is highly variable throughout the liver, a diagnosis of @entity82 , which implies @entity82 and regenerative nodules throughout the liver, should be made with great caution on biopsy.
