This study was funded by the Department of Pathology and Immunology at Washington University in St. Louis (St. Louis, MO).
Parenchymal alterations in cirrhotic livers in patients with hepatopulmonary syndrome or portopulmonary hypertension
Article first published online: 3 JUN 2013
Copyright © 2013 American Association for the Study of Liver Diseases
Volume 19, Issue 7, pages 741–750, July 2013
How to Cite
Ma, C., Crippin, J. S., Chapman, W. C., Korenblat, K., Vachharajani, N., Gunter, K. L. and Brunt, E. M. (2013), Parenchymal alterations in cirrhotic livers in patients with hepatopulmonary syndrome or portopulmonary hypertension. Liver Transpl, 19: 741–750. doi: 10.1002/lt.23632
- Issue published online: 25 JUN 2013
- Article first published online: 3 JUN 2013
- Accepted manuscript online: 5 MAR 2013 01:37PM EST
- Manuscript Accepted: 18 FEB 2013
- Manuscript Revised: 29 NOV 2012
- Manuscript Received: 5 NOV 2012
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPH) are distinct pulmonary vascular complications of cirrhosis. Little is known about possible associated hepatic histopathological features. Explanted livers from patients clinically diagnosed with HPS (n = 8) or PPH (n = 7) and cirrhotic explants from controls (n = 30) without HPS or PPH were evaluated with trichrome histochemistry, anti–glutamine synthetase (anti-GS), and anti-CD34 immunohistochemistry (IHC). Trichrome stains were characterized by cirrhotic nodules (CNs) of various sizes, including incomplete septal cirrhosis (ISC). ISC was overrepresented in the HPS (4/8 or 50%) and PPH livers (3/7 or 43%); in addition, neither group had micronodular cirrhosis. The control explants showed the entire spectrum of nodules: micronodular, macronodular, mixed CNs, and ISC (P = 0.04). The variability of cirrhosis severity was shown with the Laennec grading system (0-6). The cirrhosis of the majority of the HPS (6/8) and PPH livers (6/7) was scored as mild, whereas the control explants were more evenly distributed across the mild (14/30) and moderate/severe grades (16/30). GS positivity was retained in a perivenular location as the dominant pattern in each explant group. CD34 staining detected capillarized sinusoids of CNs as well as vascular channels within septa, but no significant differences were found between the groups. None of the observed light microscopy or histochemistry and IHC patterns showed a correlation with the underlying liver disease. Although our results demonstrate variable architectural and vascular remodeling within and between explant livers regardless of the presence or types of pulmonary complications, there were differences in explants with HPS or PPH versus controls that correlated with less severe cirrhosis. Liver Transpl 19:741–750, 2013. © 2013 AASLD.