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Multivisceral intestinal transplantation: surgical pathology
1Department of Pathology, University of Pittsburgh School of Medicine, Pennsylvania.
Pediatric Pathology
|January 1, 1989
Summary
This study details surgical pathology in pediatric multivisceral abdominal transplant recipients. Despite challenges, key findings included Epstein-Barr virus-related lymphoproliferative disease and bacterial translocation, with no graft-versus-host disease observed.
Area of Science:
- Pediatric surgical pathology
- Transplantation immunology
- Gastrointestinal pathology
Background:
- Multivisceral abdominal transplantation in children is complex, with limited established diagnostic criteria for post-transplant complications.
- Simultaneous occurrence of multiple pathological processes complicates diagnosis.
Observation:
- Surgical pathology of two pediatric multivisceral abdominal transplant survivors (1 and 6 months post-transplant) was analyzed.
- Histology and immunohistology (including HLA staining) were used for graft-versus-host differentiation.
- Functional T-cell analysis corroborated morphological findings.
Findings:
- Graft-versus-host disease was notably absent.
- Rejection was severe in one patient and absent in the other.
- Both patients exhibited Epstein-Barr virus-related lymphoproliferative disease.
- Bacterial translocation through the gut wall was a common feature.
Implications:
- Highlights the spectrum of diagnostic challenges in pediatric multivisceral transplantation.
- Emphasizes the importance of integrated diagnostic approaches, including immunohistochemistry and functional assays.
- Identifies key post-transplant complications like EBV-related PTLD and bacterial translocation in this population.