INTRAHEPATIC ARTERIOPATHY ASSOCIATED WITH PRIMARY NONFUNCTION OF LIVER ALLOGRAFTS

In this report we describe two cases of liver allograft primary non-fu nction in which the donor organs were obtained from patients with a lo ng-standing history of hypertension and placed in normotensive 2 recip ients. Examination of these failed grafts showed marked luminal narrow ing of the medium and large intrahepatic arteries along with extensive hepatocellular necrosis. No evidence of cellular allograft rejection was present. Preoperative frozen section evaluation of the donor liver failed to detect any pathological changes in the donor organs. Morpho metric studies showed a statistically significant luminal narrowing of the medium arteries in these patients compared with controls with gra ft failure because of other causes (P < .0001). To our knowledge there are no previous reports describing this finding in the literature. We hypothesize that the arterial narrowing in these livers resulted in c ompromised blood flow to the organ after transplantation into a normot ensive patient. Further studies are necessary to determine the frequen cy of these changes in the hypertensive population. Such studies may l ead to the development of criteria that will identify potential donors who are likely to have such changes before organ procurement. HUM PAT HOL 25:960-963. Copyright (C) 1994 by W.B. Saunders Company