Use of bile cytology for early diagnosis of complications in orthotopic liver transplantation

We conducted a daily analysis of bile cellularity in 25 patients undergoing 29 orthotopic liver transplants (OLT) and correlated the cytological param eters with the clinical outcome of each patient. The 16 patients without co mplications only showed slides with cells during the first 4-5 postoperativ e days. The four patients with primary non-function (PNF) of the graft had a high cell density up to the time of the retransplant, with a preponderanc e of polymorphonuclear (PMN) leucocytes (59.2%) and epithelial cells (29.2% ). During the episodes of sepsis (n = 3) and rejection (n = 7) we noted the sudden appearance of high cellularity, almost exclusively PMN leucocytes ( 96.5%), and a preponderance of PMN leucocytes (84.2%) with appreciable perc entages of mononuclear cells and macrophages as well as the early appearanc e of lymphoblasts in the rejection episodes. Our results show that bile cyt ology can be a useful method for diagnosing graft complications in liver tr ansplantation.