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DOI: 10.1055/s-0033-1361002
The regenerative capacity of the biliary epithelium influences biliary complications following liver transplantation
Background: The aim of this study was to examine the influence of the regenerative activity in damaged biliary epithelium on the development of biliary complications after liver transplantation.
Methods: Common bile duct samples during donor hepatectomy, after cold storage, and after reperfusion were compared to healthy controls by H&E staining and immunohistochemistry for the proliferation marker Ki-67 and further factors necessary for cell regeneration. The bile duct damage score was used to quantify biliary epithelial injury. The results were correlated with the regeneration of biliary epithelial cells.
Results: Control (N = 16) and donor hepatectomy bile ducts (N = 10) showed regular epithelial morphology and regenerative capacity. After cold storage (N = 37) and even more after reperfusion (N = 62), epithelial damage, as quantified by the bile duct damage score, was markedly increased, and the biliary regenerative capacity was detected at reduced levels. Within these groups, patients with lower regenerative capacity had an increased risk of biliary complications.
Conclusions: In many cases, the common bile duct epithelium shows considerable damage after cold ischemia with further damage occurring after reperfusion. A part of these damaged bile ducts show a diminished regenerative capacity which leads to an increased risk of biliary complications.