Enhanced lymphangiogenesis in the left lateral segment of a biopsied liver during portoenterostomy for biliary atresia
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In brief
In brief
This study examines why the left lateral segment of the liver atrophies in biliary atresia patients undergoing Kasai portoenterostomy. Researchers found enhanced lymphatic vessel formation in the left liver segment correlates with fibrosis severity and patient age at surgery, suggesting immune dysregulation may drive segmental atrophy.
- Left lateral segment (LLS) of liver shows consistently higher hepatitis-like findings scores than right anterior segment in biliary atresia
- Lymphangiogenesis in LLS correlates with degree of fibrosis and older age at Kasai portoenterostomy
- Enhanced lymphatic vessel formation in LLS may be linked to immune dysregulation and segment atrophy in biliary atresia
- Pre-operative CRP levels correlate with left-to-right ratio of lymphatic vessels, suggesting inflammatory component
- Lymphatic vessel proliferation increases proportionally with fibrotic area across all liver segments in biliary atresia
Written by the GCMD Library team from the article.
Abstract
Purpose
We investigate the histopathology of the portal vein branches and lymphatic vessels to elucidate the mechanism of atrophy of the left lateral segment (LLS) of the liver in biliary atresia (BA).
Methods
LLS and right anterior segment (RAS) liver biopsy samples obtained during Kasai portoenterostomy (KPE) from ten consecutive patients with BA underwent histopathological investigation of the portal vein and lymphatic vessels using double chromogenic immunostaining for CD31/D2-40 and the hepatitis-like findings (HLF) score. Each parameter and clinical data were compared between prognostic groups.
Results
HLF scores in the LLS were always higher than those in the RAS. There was no difference in portal vein and lymphatic vascular morphology, whereas the number of lymphatic vessels was correlated with the fibrotic area of all specimen areas. Left-to-right ratio of the number of lymphatic vessels was correlated with the age at KPE (r = 0.784, p = 0.007) and the pre-KPE CRP value (r = 0.723, p = 0.018).
Conclusions
Lymphangiogenesis on the LLS compared to the RAS was significantly correlated with the degree of fibrosis and the age at KPE. Further investigation is warranted to clarify the causes of LLS atrophy and lymphangiogenesis relevant to immune dysregulation.