Brief Article
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World J Gastroenterol. Nov 21, 2013; 19(43): 7772-7777
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7772
Biliary casts after liver transplantation: Morphology and biochemical analysis
Yu-Long Yang, Cheng Zhang, Mei-Ju Lin, Li-Jun Shi, Hong-Wei Zhang, Jing-Yi Li, Qiang Yu
Yu-Long Yang, Cheng Zhang, Mei-Ju Lin, Li-Jun Shi, Hong-Wei Zhang, Jing-Yi Li, Qiang Yu, Department of Minimally Invasive Biliary Surgery, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, Liaoning Province, China
Author contributions: Yang YL conceived and designed the study; Yang YL, Zhang C, Lin MJ, Shi LJ, Zhang HW, Li JY and Yu Q performed the examinations; Yang YL, Lin MJ, Shi LJ, Zhang HW and Li JY performed the surgery; and Zhang C wrote the manuscript.
Correspondence to: Yu-Long Yang, PhD, Department of Minimally Invasive Biliary Surgery, Affiliated Zhongshan Hospital of Dalian University, Jiefang Street, No.6, Zhongshan District, Dalian 116001, Liaoning Province, China. yyl516@126.com
Telephone: +86-411-62893656 Fax: +86-411-62893555
Received: April 24, 2013
Revised: September 24, 2013
Accepted: September 29, 2013
Published online: November 21, 2013
Processing time: 84 Days and 13.7 Hours
Abstract

AIM: To investigate the pathogenesis of biliary casts after liver transplantation relative to their morphology and biochemical markers.

METHODS: The microstructure of biliary casts was assessed using scanning electron microscopy and Hematoxylin and eosin staining assessed their histology. The expression levels of CD3, CD5, CD34, CD68 and CD79a in these biliary casts were evaluated immunohistochemically.

RESULTS: Biliary casts differed widely in their microstructure, with some containing blood vessels positive for CD34 and collagen fibers with positive Masson staining. Large numbers of neutrophils and other inflammatory cells were present, but only on the edge of the biliary casts; although the boundaries were clear without crossover. None of the biliary casts contained T-lymphocytes, B-lymphocytes, macrophages and other inflammatory cells.

CONCLUSION: The microcostructure of biliary casts differed. Bacteria and acute rejection are not clearly related to their formation.

Keywords: Biliary cast; Biliary cast syndrome; Liver transplantation; Blood vessels; Acute rejection

Core tip: This experimental study employed scanning electron microscopy, Hematoxylin and eosin staining and immunohistochemistry to investigate biliary casts following liver transplantation. The results indicated that blood vessels and collagen fibers are present in biliary casts; however, bacteria and acute rejection are not clearly related to their formation, as evidenced by blood vessels positive for CD34 and collagen fibers with positive Masson staining, and no T-lymphocytes, B-lymphocytes, macrophages and other inflammatory cells. Thus, although bile duct injury after liver transplantation is significantly associated with biliary cast formation, their role in acute rejection is unclear.