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Histologic diagnosis of rejection by using cystoscopically directed needle biopsy specimens from dysfunctional pancreatoduodenal allografts with exocrine drainage into the bladder.
Carpenter, H A; Engen, D E; Munn, S R; Barr, D; Marsh, C L; Ludwig, J; Perkins, J D.
Afiliação
  • Carpenter HA; Division of Pathology, Mayo Clinic, Rochester, Minnesota 55905.
Am J Surg Pathol ; 14(9): 837-46, 1990 Sep.
Article em En | MEDLINE | ID: mdl-2389814
ABSTRACT
To determine the histologic features of rejection and to identify nonrejection causes of human pancreatic allograft dysfunction, we analyzed 31 needle biopsy specimens (17 pancreatic, 14 duodenal) obtained under cystoscopic direction from 15 dysfunctional pancreatoduodenal allografts with exocrine drainage into the bladder. Eight allografts undergoing rejection showed the most common histologic features of rejection to be diffuse mixed inflammatory infiltrates of pancreatic acinar tissue and duodenum wall. Diffuse infiltration of pancreatic acinar tissue by neutrophils was the earliest histologic change in rejection. Seven dysfunctional allografts not undergoing rejection ("nonrejection") showed a normal pancreas or various changes including acinar dilation with inspissation of secretions, fibrosis, cytomegalovirus inclusions, and enzymatic necrosis. The histologic changes in the duodenum paralleled those in the pancreas in both rejection and nonrejection allografts. We conclude that the histologic features of rejection in pancreatoduodenal allografts are distinctive. The changes seen in biopsy specimens accurately reflect the state of the graft and can be used to diagnose rejection and to identify other causes of graft dysfunction. Biopsy samples from the duodenum as well as the pancreas are diagnostically useful. The biopsy findings can be used to guide the clinical management of rejection and in the development of other noninvasive tests for rejection.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Biópsia por Agulha / Transplante de Pâncreas / Duodeno / Rejeição de Enxerto Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Am J Surg Pathol Ano de publicação: 1990 Tipo de documento: Article
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Biópsia por Agulha / Transplante de Pâncreas / Duodeno / Rejeição de Enxerto Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Am J Surg Pathol Ano de publicação: 1990 Tipo de documento: Article