Abstract
In liver transplantation, liver graft ischemia-reperfusion injury occurs mainly due to cold preservation and warm reperfusion. In this research, we study the affection of plasma protein of the donor on liver graft during cold preservation and warm reperfusion. In this study, 34 liver transplantations were performed from 2007 to 2010, and the clinical data were collected retrospectively from the Dongfang Hospital database. 34 specimens were harvested from 34 liver grafts when graft trimming as Group A and 34 specimens harvested from the same 34 liver grafts during liver transplantation surgery but before abdominal closure as B group. All liver tissue specimens were fixed with 40 g/L neutral formalin, embedded in paraffin. Light microscopy, transmission electron microscopy, Periodic Acid-Schiff (PAS) stain and immunohistochemical stain of IgG, IgM, IgA, C3d, C4d, Fib, C1q, and CD61 were used. In this study, we found that eosinophilic bodies emerged in liver lobes during liver transplantation which had not been reported previously in the literature. 1) Protein globules were found exclusively in liver graft specimens. The globules were round or oval with sharp edges, measured approximately 1.59 to 9.41 μm in diameter, and were scattered in the liver sinusoids or space of Disse or hepatocyte cytoplasm, were stained with IgG, IgM, IgA, Fib, C3d by immunohistochemical staining; 2) There was no statistical significant difference of protein globules number between A group and B group (P > 0.05); 3) IRI score of B group was not correlated with protein globules number (P > 0.05). Protein globules contain plasma composition, and may form during cold preservation.
Highlights
Liver graft Ischemia-Reperfusion Injury (IRI) occurs during the cold preservation and reperfusion of the liver graft prior to transplantation into the recipient [1,2,3,4]
The B group included 34 specimens harvested from the same 34 liver grafts during liver transplantation surgery but before abdominal closure. 34 liver harvested from the recipients, 30 liver tissue with chronic hepatitis B infection, 17 surgical liver specimens with no liver lesion, 13 autopsy liver specimens with no liver lesion, and 10 liver puncture biopsies about 10 to 20 days after liver transplantation had no cold preservation injury were used in this study as control
All liver tissue specimens of A and B group split into two halves,one half were fixed with 40 g/L neutral formalin, embedded in paraffin, cut serially to 3 μm,stained with hematoxylin and eosin (H&E), periodic acid-Schiff stain (PAS), Masson’s trichrome, and immunohistochemically stained to detect the expression of IgG, IgM, IgA, C3d, C4d, fibrinogen (Fib), C1q, CD61, HBsAg and HBcAg
Summary
Liver graft Ischemia-Reperfusion Injury (IRI) occurs during the cold preservation and reperfusion of the liver graft prior to transplantation into the recipient [1,2,3,4]. This IRI includes lesions such as fatty degeneration, which may affect the recovery of graft function. Previous research by our group has shown that eosinophilic bodies emerged in liver lobes during liver transplantation [5]. These eosiniphilic bodies (or “protein globules”) had not been reported previously. Periodic Acid-Schiff (PAS) stain; immunohistochemical staining of IgG, IgM, IgA, C3d, C4d, Fib, C1q, and CD61 were used to determine the composition of the protein globules
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