A majority of primary diseases for which orthotopic liver transplantation is carried out may recur in the liver allograft, mostly in adults. As the indication criteria, transplantation surgery and post-transplantation care improve, the patients survival lengthens as well, leading to concurrently increasing incidence as well as an increase in the relevance of recurrent diseases, which are the most significant cause of late liver graft dysfunction. The frequency, clinical consequences and therapeutic options of different disease recurrence vary considerably. Even recently the worst prognosis has been associated with hepatitis C for 100% reinfection, this situation is beginning to change with new oral antiviral drugs, as has already been successfully done with hepatitis B. Among immune-mediated disorders, primary biliary cirrhosis recurrence affects 30 - 50% of transplant patients, albeit with mild consequences. Graft loss and subsequent necessity of retransplantation are observed in almost 10% of patients with primary sclerosing cholangitis recurrence. 30% prevalence rates for autoimmune hepatitis recurrence are reported but the frequency of graft loss has declined considerably due to maintenance of corticosteroid therapy. Excessive relapse of alcohol consumption in patients with liver transplant for alcoholic liver disease leads most commonly to extrahepatic complications. Recurrent non-alcoholic steatohepatitis is rarely connected with graft loss in 5 - 10 years after transplantation. The diagnosis of a recurrent disease following liver transplantation is to a large extent based on histopathological features. In the differential diagnosis, other causes of graft dysfunction must be excluded.
- Klíčová slova
- liver transplantation - recurrence - biopsy.,
- MeSH
- lidé MeSH
- nemoci jater komplikace chirurgie MeSH
- recidiva MeSH
- reoperace MeSH
- transplantace jater * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The authors submit the case history of their patient presenting with chronic cystitis, consequence of an infestation with the fluke Schistosoma haematobium. They also present the most frequent morphological forms of urogenital schistosomiasis, its complications and the possibilities of pathological differential diagnosis, based on literary data (including information from electronic data bases) on the pathomorphology and, more particularly, the histopathology of urogenital schistosomiasis. Among the general histopathological changes we see lesions that correspond to an active chronic infection with a chiefly granulomatous reaction. Calcification, pseudotumorous polypoid formations, ulcerations, obliterating fibrous lesions, epithelial transformations such as hyperplasia, metaplasia and dysplasia follow later. These changes are followed at the various sites by diverse clinical and morphological complications-posthaemorrhagic anaemia, adhesions, serious obstructions of urogenital openings and its consequences and, finally, an increased risk of pavement-cell carcinoma of the bladder. For all the above-mentioned reasons we should include the possibility of urogenital schistosomiasis into the large group of clinical and pathological aspects of differential diagnosis, when considering the etiology and treatment of inflammatory and tumorous lesions of the urogenital tract.
- MeSH
- lidé MeSH
- schistosomiasis haematobia diagnóza patologie MeSH
- ženské urogenitální nemoci diagnóza patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
