Livers from patients with apolipoprotein A-I amyloidosis are not suitable as "domino" donors.

Journal Article (Journal Article)

Orthotopic liver transplantation, by eliminating the major site of amyloidogenic protein synthesis, is currently the only definitive treatment of most hereditary amyloidoses. Because of the minimal parenchymal involvement, the explanted livers from familial amyloidotic polyneuropathy (FAP) patients have been transplanted into non-FAP patients in a "domino" fashion. The aim of this study was to evaluate the extent of amyloid deposits in explanted livers from two patients with apolipoprotein A-I amyloidosis, with the Arg26 mutation, to determine their suitability as domino donors. A detailed histologic review of the explanted livers from two patients was performed and assessed for the extent of amyloid deposition by routine and Congo red stains. Both patients had identical histopathologic features. The liver parenchymal involvement was strikingly severe. Large patches of amyloid separated hepatic cords, with accentuation around the central veins. All portal triads were consistently and markedly involved with amorphous eosinophilic deposits within the connective tissue compressing the bile ducts and vascular structures. Hilar vessels had patchy deposits. No involvement of hilar nerve branches was seen. The hepatic parenchyma is extensively involved in hereditary Apolipoprotein A-I amyloidosis, with the Arg26 mutation. These livers, removed at orthotopic liver transplantation, are not suitable for domino donation.

Full Text

Duke Authors

Cited Authors

  • Shaz, BH; Lewis, WD; Skinner, M; Khettry, U

Published Date

  • June 2001

Published In

Volume / Issue

  • 14 / 6

Start / End Page

  • 577 - 580

PubMed ID

  • 11406659

Electronic International Standard Serial Number (EISSN)

  • 1530-0285

International Standard Serial Number (ISSN)

  • 0893-3952

Digital Object Identifier (DOI)

  • 10.1038/modpathol.3880353

Language

  • eng