Histology:
Histologically, SASS has been noted to demonstrate cholestasis,
epithelial ductal regressive changes, and centrilobular zone necrosis
(1,11,12,13). If transplant biopsy were performed, SASS generally
demonstrates mild inflammation, which contrasts with the overt findings
seen during acute rejection (1). Potential consequences of SASS feature
early graft dysfunction and biliary ischemia, potentially leading to
re-transplantation (2,4).
Some institutions perform either prophylactic or post-transplant
treatment procedures in up to 25% of all transplant patients (4). The
outcome of SASS depends on the time since the hepatic artery suffered
ischemia. Therefore, it is necessary to diagnose and treat the
complication as soon as possible (14). The diagnosis of SASS is
particularly challenging as it has nonspecific signs such as elevated
LFTs, cholestasis and graft dysfunction (14).