Intrahepatic bile duct injury following bone marrow transplantation. Analysis of pathological features based on three-dimensional and histochemical observation.

A specific bile duct injury is frequently observed in the liver following bone marrow transplantation. The materials used for study consisted of liver specimens obtained from 7 autopsy cases and 2 biopsies. The pathological lesions were analyzed by reconstruction of serial sections and by immunohistochemical examination. Injury following bone marrow transplantation occurred most frequently in bile ducts right after the canalicular-ductular junction to ducts having an outer diameter of 50-60 mu, being especially prominent in those less than 30 mu in diameter. They preserved their continuity and there was neither complete destruction nor loss of bile ducts as seen in primary biliary cirrhosis. Immunohistochemical examination showed predominancy of suppressor T lymphocytes around ducts and they were frequently found adjacent to epithelial cells of bile ducts. C3 components and HLA-DR antigens were confirmed to be localized in ductular epithelia in the area where injury took place. Although their localization and site of injury did not necessarily coincide, the participation of an immunologic mechanism against injury cannot be denied. Evidence of a relation between ductular injury and cytomegalovirus infection could not be obtained.