GI and Liver Transplantation Pathology in Childhood

This chapter attempts to focus on the main indications and pathology of liver, gastrointestinal, and bone marrow transplantation. The author has attempted to restrict the findings to pediatric transplants and focuses on the salient features of all complications post transplant. The first portion on liver transplant pathology focuses on the common pediatric indications as well as the use of explanted livers as a teaching library for pediatric liver diseases. The role of the pathologist is stressed, and the complications of rejection, both acute and chronic, are highlighted. The posttransplant infections and tumors are also discussed. The important focus is on differential diagnosis and how to differentiate changes of rejection from other causes and recurrence of disease. The second part of the chapter deals with the common indications and complications of small bowel transplant along with grading of acute cellular rejection, pathology of chronic rejection, posttransplant infections, and posttransplant tumors. A brief focus on colonic and gastric transplants included as part of a multivisceral transplant is also described. The third section on complications of bone marrow transplant concentrates on the main GI complications involving the liver and gastrointestinal tracts. All sections have been illustrated amply to highlight the major pathologic points.