Oral Sessions Oral Session 37 : Non-renal DCD / ECD

Methods: We have analyzed donor bile ducts taken 1 hour after portal and arterial graft recirculation in order to assess bile duct damage caused by preservation and recirculation. Bile duct tissue specimens of 36 donors were fixed in PBS-buffered formalin and processed according to standard protocols. Results: Loss of epithelium of the bile duct being complete in 17% was a common feature in all specimens. The majority of cases (87%) showed diffuse transmural bleeding of the bile. Inflammation was generally only sparsely detected. The most remarkable alterations were observed in the arterioles: In 36% of cases, we found damage of the endothelial lining characterized by loss of endothelial cells and sub-endothelial edema. Additionally, 47% of the specimens revealed variable numbers of necrotic arterioles. In these patients, necrotic walls of the bile ducts occurred (with a total number of 20 donors). Vessels with thrombi could be detected in 42% of the specimens. Conclusions: To our knowledge, this is the first study analyzing the histology of donor bile ducts immediately after recirculation during LT. The most prominent finding was a remarkable vascular damage leading to arteriolonecrosis. Further studies should elucidate if these lesions are caused by inadequate preservation or by natural variations of the blood supply to the bile ducts.