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JPTM > Volume 45(0); 2011 > Article
The Korean Journal of Pathology 2011;45(Suppl 1): S48-S52.
doi: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S48
Clinicopathologic Analysis of the Liver Explant with Severe Hepatitis A Virus Infection.
Joo Young Kim, Sung Gyu Lee, Shin Hwang, Ji Hoon Kim, Se Jin Jang, Eunsil Yu
1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. esyu@amc.seoul.kr
2Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
ABSTRACT
The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.
Key Words: HAV infection; Liver transplantation; Cholestasis; Venulitis