Liver вiopsy in predicting morphological changes after liver transplantation in children
DOI:
https://doi.org/10.15574/PS.2025.4(89).5458Keywords:
liver transplantation, children, histopathological changes, fibrosis, cholestasis, steatosis, inflammatory infiltrates, biopsyAbstract
Subclinical histopathological changes in the transplanted liver are a common issue after liver transplantation, as they often progress without clinical manifestations and may not be detected by standard laboratory tests.
Aim - to evaluate histopathological changes in liver grafts in pediatric recipients after transplantation and their association with clinical and biochemical parameters.
Materials and methods. The study included 48 children after liver transplantation under dynamic follow-up at a single transplant center. Liver biopsies were performed according to long-term follow-up protocols. Histological analysis was conducted using the Ishak score to assess fibrosis, inflammatory activity, cholestasis, bile duct injury, and steatosis. Standard liver function tests (alanine aminotransferase, aspartate aminotransferase, total bilirubin, gamma-glutamyl transpeptidase) were analyzed for correlations with morphological changes.
Results. Histopathological changes were detected in 44 (92.1%) patients, even in the absence of abnormal laboratory values or clinical symptoms. Fibrosis was the most common finding (mean Ishak score 3.2±1.4). Portal inflammatory infiltrates were present in 54.2% of patients, cholestasis in 43.8%, steatosis in 37.5%, and bile duct injury in 31.3%. Correlation between laboratory markers and morphological changes was weak and statistically insignificant.
Conclusions. Subclinical histopathological changes in transplanted livers after transplantation are frequent and diverse. Liver biopsy remains critical for early detection of structural alterations and optimization of immunosuppressive therapy, even when laboratory tests are normal.
The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the child and child's parents was obtained for the research.
The authors declare no conflict of interest.
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