LIVER BIOPSY IN MODERN MEDICINE Edited by Yoshiaki Mizuguchi Liver Biopsy in Modern Medicine Edited by Yoshiaki Mizuguchi Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Mirna Cvijic Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright Sebastian Kaulitzki, 2011. Used under license from Shutterstock.com First published September, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Liver Biopsy in Modern Medicine, Edited by Yoshiaki Mizuguchi p. cm. ISBN 978-953-307-883-0 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Liver Biospy in Management of Liver Disease 1 Chapter 1 Liver Biopsy in Transplantation: Nonalcoholic Fatty Liver Disease and the Eosinophils 3 Kishi, Sugawara and Kokudo Chapter 2 Histopathological Diagnosis of Non-Alcoholic and Alcoholic Fatty Liver Disease 13 Andrea Tannapfel and Berenike Flott-Rahmel Chapter 3 Metabolic Steatosis & Fibrosis: Review of the Non-Invasive Tools for Diagnosis and Screening 35 Miette Véronique, Abdennour Meriem, Sandrin Laurent and Sasso Magali Chapter 4 Reversal of Liver Fibrosis: A Review 63 Mona H. Ismail Chapter 5 Hepatic Oxidative Stress: Role of Liver Biopsy 77 Mahmoud Rushdi Abd Ellah Chapter 6 Clinical Variants of Primary Sclerosing Cholangitis: When Does Liver Biopsy Make the Diagnosis? 89 Annarosa Floreani Chapter 7 Evaluation of Radiofrequency Ablation as a Method for Treatment of Hepatocellular Carcinoma 95 Heba Mohamed Abdella Chapter 8 Percutaneous Liver Fiducial Implants: Techniques, Materials and Complications 107 David Roberge and Tatiana Cabrera VI Contents Chapter 9 Drugs and Toxins Effects on the Liver 117 Piero Luigi Almasio, Anna Licata and Claudia Randazzo Chapter 10 Adverse Effects of Drugs and Toxins on the Liver 137 Jan Schjøtt Part 2 Liver Biopsy in Transplantation 163 Chapter 11 The Liver Biopsy During Organ Procurement 165 Johannes W. Rey and Jochen W.U. Fries Chapter 12 Initial Poor Graft Dysfunction and Primary Graft Non-Function After Orthotopic Liver Transplantation 183 Chen Hao, Xie Junjie, Shen Baiyong, Deng Xiaxing, Tao Ran, Peng Chenghong and Li Hongwei Chapter 13 Role of Liver Biopsy After Liver Transplantation 207 Marco Carbone and James Neuberger Chapter 14 Immunohistochemical Staining of Liver Grafts for Recurrent Hepatitis C After Liver transplantation 219 Hiroshi Sadamori, Tetsuya Ogino, Takahito Yagi and Toshiyosi Fujiwara Chapter 15 The Present Role of Liver Biopsy in Kidney Transplant Candidates in the Management of Hepatitis B and C Patients 229 Teresa Casanovas, Carme Baliellas and Maria Carmen Peña Cala Part 3 Liver Biopsy in Children 251 Chapter 16 Needle Biopsy in Children With Liver Diseases 253 Pietrobattista A., Alterio A., Natali G., Fruhwirth R., Comparcola D., Sartorelli M.R. and Nobili V. Chapter 17 Liver Biopsy as a Useful Tool in the Management of Autoimmune Liver Diseases in Childhood 265 Giuseppe Maggiore, Marco Sciveres and Aurelio Sonzogni Chapter 18 Bile Duct Paucity in Infancy 295 Consolato Sergi, Wesam Bahitham and Redha Al-Bahrani Part 4 Viral Hepatitis 305 Chapter 19 Occult Hepatitis C Virus Infection: Where are We Now? 307 Nicot Florence, Kamar Nassim, Rostaing Lionel and Izopet Jacques Contents VII Chapter 20 Hepatitis C Virus Proteins Induce Cirrhosis Antigen Expression on Human Hepatoma Cells In Vitro: Implications for Viral Mechanisms in Hepatitis C Fibrogenesis 335 Alka Saxena, Sampa Pal, Stephen J. Polyak, Sy Nakao, Igor Tikonokov, Tao Su, Thao Tran, Wan Chong Qiu, Jessica Wagoner, Lisa Thomassen, Margaret Shuhart and David R. Gretch Chapter 21 New Aspects of Natural History and Pathogenicity of Hepadnaviral Infection and Hepatocyte Function Revealed by the Woodchuck Model of Hepatitis B 355 Patricia M. Mulrooney-Cousins and Tomasz I. Michalak Preface Liver biopsy, first performed by Paul Ehrlich in 1883, remains an important diagnostic procedure for the management of hepatobiliary disorders and the candidate/donated organ for transplantation. The book "Liver biopsy in Modern Medicine" comprises 21 chapters covering the various aspects of the biopsy procedure in detail and provides an up-to-date insightful coverage to the recent advances in the management of the various disorders with liver biospy. This book will keep up with cutting edge understanding of liver biopsy to many clinicians, physicians, scientists, pharmaceutics, engineers and other experts in a wide variety of different disciplines. Yoshiaki Mizuguchi, MD, PhD, Department of Surgery for Organ Function and Biological Regulation Nippon Medical School, Graduate School of Medicine, Japan [...]... potential information gain and its consequences against the resources invested and the complication rate, i.e consider the clinical context No blanket recommendation for liver biopsy in either suspected or confirmed fatty liver disease can currently be given The indication for biopsy in assumed fatty liver disease depends on the clinical context Decisive is the likelihood that the biopsy findings will... embedding in paraffin with the usual dehydration and preparation of routine stains such as haematoxylin and eosin, Berlin blue for demonstration of iron, PAS-diastase stain and reticulin and connective tissue staining) Sirius red staining is recommended for morphometric assessment Immunohistological staining is not routinely required An immunohistochemical reaction with antibodies to keratin 7 or 19... can be confirmed only by biopsy, the possibility to encounter the liver donor with NAFLD will also increase Whether hepatic steatosis is associated with impaired liver regeneration or an increased risk of morbidity or mortality after liver surgery is 4 Liver Biopsy in Modern Medicine controversial Selzner and Clavien8 showed impaired liver regeneration in steatotic livers using rat models Similarly,... (staging) Harvesting and processing of the biopsy cylinder should observe the standard recommendations for liver biopsy The cylinder should contain representative tissues, be about 25 mm long and or contain 15 portal fields (Rousselet et al., 2005) Fixation and 19 Histopathological Diagnosis of Non-Alcoholic and Alcoholic Fatty Liver Disease processing are routine (4% neutral buffered formalin, embedding... steatotic rat liver: disruption at two different levels in the regeneration pathway Hepatology 31:35-42, 2000 10 Liver Biopsy in Modern Medicine [9] Vetelainen R, van Vliet AK, van Gulik TM: Severe steatosis increases hepatocellular injury and impairs liver regeneration in a rat model of partial hepatectomy Annals of surgery 245:44-50, 2007 [10] Hsiao IT, Lin KJ, Chang SI, et al: Impaired liver regeneration... findings may be helpful in differential diagnosis (Brunt, 2002; Brunt, 2007), although to date there is no published evidence: Fat Microvesicular steatosis and “foamy” degeneration of the liver seem to indicate incipient hepatic decompensation in patients with ASH and are less common in NASH 24 Liver Biopsy in Modern Medicine Patients with NASH usually exhibit more advanced fatty degeneration of liver. .. evaluation remains the sole method of distinguishing steatosis from advanced forms of NAFLD Histopathological Diagnosis of Non-Alcoholic and Alcoholic Fatty Liver Disease 17 Thus, liver biopsy is the gold standard for confirmation of the diagnosis and for determination of the inflammatory activity and possible presence of fibrosis in fatty liver disease In deciding whether biopsy is indicated, one... steroids alone to downregulate eosinophils cannot be ignored Table 3 Summary of the studies evaluating blood of histologic eosinophila with the diagnosis of acute cellular rejection (ACR) AEC, absolute eosinophil count; REC, percentage of eosinophil count in the whole leukocyte count 8 Liver Biopsy in Modern Medicine Notably, blood eosinophilia a few days before biopsy is associated with ACR Although... ascertainment of its effect (e.g weight reduction, physical activity) Participation in clinical studies or protocol biopsies Special indications (e.g assessment of explanted livers) In this context liver biopsy must clarify the following points: Confirmation of possible or assumed fatty liver; clarification of steatohepatitis; confirmation or exclusion of liver disease other than fatty liver disease (typing)... between ACR and recurrent HCV Unitt et al.48 reported that minichromosome maintenance Nonalcoholic Fatty Liver Disease and the Eosinophils 9 protein-2 (Mcm-2) visualized by immunohistochemical staining in lymphocytes infiltrating into the portal tracts is more frequently expressed in ACR than in HCV recurrence The number of Mcm-2–positive lymphocytes in the portal tract was not correlated with the ACR grade, . LIVER BIOPSY IN MODERN MEDICINE Edited by Yoshiaki Mizuguchi Liver Biopsy in Modern Medicine Edited by Yoshiaki Mizuguchi Published by InTech Janeza Trdine. Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Liver Biopsy in Modern Medicine, . reported that minichromosome maintenance Nonalcoholic Fatty Liver Disease and the Eosinophils 9 protein-2 (Mcm-2) visualized by immunohistochemical staining in lymphocytes infiltrating into the