imaging of liver transplantation complications

Graft

calcifications and dysfunction following liver transplantation. A: Serum Bilirubin levels (μmol/L) for patient 1 (solid line) and for patient 2 (dashed line). The arrowheads indicate the time points where calcifications were detected. B: International Normalization Ratio (INR) for patient 1 (solid line) and for patient 2 (dashed line). Arrowheads indicate the time points where calcifications were detected. C: Computed Tomography of patient 2. The arrow points an area in the right liver with the same density as the spinal column (arrowhead). D: Picture of the explant liver during retransplantation of the same patient (case 2). The arrow shows the abnormal area of the right liver correlating with the computed tomography findings. E: Light microscopy of epoxy embedded semi-section obtained from the liver biopsy from patient 1. The image shows moderate calcification (microcalcification) throughout the section. The arrow indicates a representative pattern of calcification. F: Light microscopy of epoxy embedded semi-section obtained from the tissues of the explant, following liver retransplantation of patient 2. The image shows the interface between calcified region (upper right) and non-calcified adjacent hepatic cells (lower left region). G: Light microscopy image showing a higher magnification of calcified region as shown in F. The bright and high contrast regions represent massive mineralization of hepatic cells of the explant, following retransplantation. H: Transmission electron microscopy images of ultrathin section obtained from the transitional zone between calcified and non-calcified tissue. Showing the mode of calcification and textural organization of hydroxyapatite crystal aggregates (dark contrast) within cytoplasmic region of the cell. Note alteration of the nucleus in the center.