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M9480428.TXT
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1994-08-20
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Document 0428
DOCN M9480428
TI Recurrent and de novo giant cell hepatitis after orthotopic liver
transplantation.
DT 9410
AU Pappo O; Yunis E; Jordan JA; Jaffe R; Mateo R; Fung J; Demetris AJ;
Department of Pathology, University of Pittsburgh, PA 15213.
SO Am J Surg Pathol. 1994 Aug;18(8):804-13. Unique Identifier : AIDSLINE
MED/94311410
AB This study examines the clinical and pathologic course of seven patients
who developed giant cell hepatitis (GCH) after liver transplantation.
Five of these patients also had GCH as their native liver disease and
experienced a particularly aggressive course because of recurrent
disease, beginning 1-21 months after transplantation. Two died and
another two required hepatic retransplantation because of recurrent GCH;
one of them had GCH recurrence in a second liver allograft. A remaining
patient with recurrent GCH is alive 6 years after transplantation.
Follow-up of the two patients who developed de novo GCH between 8 and 24
months after hepatic transplantation showed active micronodular
cirrhosis in one and persistent giant cell transformation in the other
at 4 years. All of the patients were serologically negative for
hepatitis C virus, hepatitis B virus, and human immunodeficiency virus
before transplantation. One patient became positive for hepatitis C
virus after transplantation. Two patients had an associated autoimmune
syndrome, which could have been accounted for by the GCH. None had a
history of drug exposure. Interestingly, human papilloma virus (HPV)
type 6 was detected by PCR analysis of liver tissues with GCH from one
of three cases before and three of four cases after transplantation.
This small series shows that GCH occurs in liver allografts, but it is
uncommon. Documentation of recurrent disease in five of seven patients
suggests that GCH in a subgroup of patients may be related to a
transmissible agent, or that a particular recipient may injure livers in
a way that elicits a giant cell reaction.
DE Adult Base Sequence Case Report Child Child, Preschool Female
Giant Cells/*PATHOLOGY Hepatitis/*PATHOLOGY Human Infant Liver
Cirrhosis/PATHOLOGY Liver Transplantation/*PATHOLOGY Male Middle Age
Molecular Sequence Data Polymerase Chain Reaction Recurrence Support,
Non-U.S. Gov't JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).