case_images: PMC2754079_01
case_images: PMC2754079_02
case_images: Native liver: 3000 g liver (expected weight 1500-1800 g) with dull yellow-green geographic necrosis and subcapsular blood.
case_images: GRP2009-713937.001.jpg
case_images: PMC2754079_02_GRP2009-713937.001.jpg
case_images: fig1
case_images: Gross inspection of the native liver revealed obvious hepatic rupture, with the organ surrounded by hematoma (Figure 1).
case_images: Native liver (40x, H&E section): at low power, one may appreciate the interface between viable and necrotic hepatic tissue.
case_images: GRP2009-713937.002.jpg
case_images: PMC2754079_02_GRP2009-713937.002.jpg
case_images: fig2
case_images: Histology demonstrated massive hepatic necrosis, marked steatosis, widespread bile ductular proliferation, profound cholestasis, and necrotic vessels with intravascular thrombi (Figures 2 and 3).
case_images: Native liver (100x, H&E section): higher power view of the interface in the native liver between viable and necrotic hepatic tissue. Note the cytologic changes of hepatocellular injury in the viable tissue.
case_images: GRP2009-713937.003.jpg
case_images: PMC2754079_02_GRP2009-713937.003.jpg
case_images: fig3
case_images: Histology demonstrated massive hepatic necrosis, marked steatosis, widespread bile ductular proliferation, profound cholestasis, and necrotic vessels with intravascular thrombi (Figures 2 and 3).
case_images: First allograft (400x, H&E section): portal areas show areas of cholangitis. No features of acute cellular rejection. The parenchyma surrrounding this portal area appears viable.
case_images: GRP2009-713937.004.jpg
case_images: PMC2754079_02_GRP2009-713937.004.jpg
case_images: fig4
case_images: Biliary obstruction, vascular thromboses and infections, including cytomegalovirus, were excluded (Figure 4).
case_images: Explant of Allograft: 2531 g liver (expected weight 1500-1800 g) congested parenchyma with approximately 30% necrosis of the left lobe.
case_images: GRP2009-713937.005.jpg
case_images: PMC2754079_02_GRP2009-713937.005.jpg
case_images: fig5
case_images: Histology of the failed allograft demonstrated numerous areas of hemorrhagic necrosis; 30% of the left lobe was completely necrotic (Figures 5, 6, and 7).
case_images: Allograft (40x, H&E section).
case_images: GRP2009-713937.006.jpg
case_images: PMC2754079_02_GRP2009-713937.006.jpg
case_images: fig6
case_images: Histology of the failed allograft demonstrated numerous areas of hemorrhagic necrosis; 30% of the left lobe was completely necrotic (Figures 5, 6, and 7).
case_images: Allograft (100x, H&E section): higher power view of large zones of necrosis abutting adjacent viable hepatic tissue.
case_images: GRP2009-713937.007.jpg
case_images: PMC2754079_02_GRP2009-713937.007.jpg
case_images: fig7
case_images: Histology of the failed allograft demonstrated numerous areas of hemorrhagic necrosis; 30% of the left lobe was completely necrotic (Figures 5, 6, and 7).