Liver disease in renal transplant recipients: A clinicopathologic study, with emphasis on alteration of bile duct epithelium

Abstract

Twenty seven post-mortem and eight biopsied specimens of the liver from patients who had undergone allogeneic renal transplantation were studied. We found a peculiar change of interlobular bile duct, which was characterized by markedly swollen, eosinophilic granular cytoplasm of bile duct epithelium. The finding resembled hepatocytes, thus we called it heptocellular metaplasia of interlobular bile duct epithelium. The epithelium showing hepatocellular metaplasia was PAS-positive and PAS-negative after diastase digestion. In immunohistochemical staining, it demonstrated positive reaction for albumin, whilst, keratin and cytokeratin were negative. Hepatocellular metaplasia was also seen in the liver specimens from some patients with chronic renal failure and chronic active hepatitis B. It was noticed that in renal transplant recipients with hepatocellular metaplasia that a good correlation between hepatocellular metaplasia and elevation of serum γ-GTP was recognized. Hepatocellular metaplasia does not always signify adverse reaction to man, however, it seems to be an interesting finding to us when considering relation between morphological alteration and elevation of enzyme associated with biliary tract.