Consultation Services in Hepatic and Transplantation Pathology
Scope of ServicesThe Division of Hepatic and Transplantation Pathology, Department of Pathology, University of Pittsburgh Medical Center offers a comprehensive consultation service in hepatic and solid organ transplantation pathology to community and university-based physicians. The scope of this service encompasses the following:
- Evaluation of post-transplant biopsies:
Allograft dysfunction after liver, kidney, heart, pancreas, lung or intestinal transplantation may result from infection, ischemia, rejection, technical complications, recurrent disease or post-transplant malignancies. Tissue biopsies play a central role in the differential diagnosis of these various possibilities and in the planning of treatment strategies. Interpretation of the observed histopathological changes requires experience, for which the members of the Hepatic and Transplantation Pathology Division have unmatched qualifications.
- Evaluation of liver, lung, heart, intestinal and kidney disease in prospective transplantation candidates:
A pre-transplant biopsy aids in determining the cause of the underlying liver, kidney, intestinal, lung or heart disease, and in confirming that the observed histopathological changes reflect irreversible damage. Transplantation may be contraindicated if the disease is systemic (e.g. metastatic carcinoma in the liver), or potentially reversible (e.g. subacute hepatic failure).
- Examination of native explanted organs:
A complete determination of the native organ disease may not always be possible by pre-transplant biopsy sampling. Extensive evaluation of the resected organ may be necessary to confirm a preoperative diagnosis (e.g. primary sclerosing cholangitis), or to obtain additional tissue for special studies (e.g. hepatitis C PCR).
Submission of SpecimensSpecimens should be sent to:
Hepatic and Transplantation Pathology Consultation Service
Attn: Pathology Coordinator
UPMC Montefiore University Hospital
3459 Fifth Avenue, Room E-733
Pittsburgh, PA 15213
A completed Transplant Pathology Consultation Request Form must be included with each specimen. (Click on the link to download the form in .pdf format.) When available, a copy of the referring pathologist's surgical report should also be submitted. If prior notification is given on Friday, arrangements can be made to receive specimens sent by a commercial courier on the weekend. All tissue blocks will be returned. Microscopic slides will be retained unless the referring physician requests their return.
Mechanism of BillingOur aim is to make the service as "user-friendly" as possible. We will primarily seek payment from the institution requesting our services; however, should the submitting physician make alternative billing requests, such as billing the patient or the patient's insurance company, our best efforts will be made to accommodate these requests. For specific questions on the billing process, please contact:
(412-647-7645 in the Pittsburgh area)
Laboratory FacilitiesThe University of Pittsburgh is the largest transplantation program in the world. In 1994, 310 liver, 185 kidney, 40 heart, 25 pancreas and 63 lung transplantation procedures were performed. More than 5,000 tissue specimens obtained from transplant recipients are accessioned annually in the Anatomic Pathology Laboratories. Facilities for immunofluorescence and electron microscopy are available.
An extensive arsenal of immunohistochemical and in-situ hybridization procedures is available to detect the following viruses: Cytomegalovirus, Herpes simplex, Varicella-zoster, Epstein-Barr virus, Hepatitis B, Hepatitis D, Adenovirus, JC virus, and SV40 virus. We also have available in-situ hybridization probes to detect the X and Y chromosomes. This panel can be useful in distinguishing between donor and recipient tissues/cells, which assists in making the diagnosis of graft versus host disease after transplantation.
The laboratories are inspected by the College of American Pathologists, and licensed by the Commonwealth of Pennsylvania.
Consultants on Staff
Anthony J. Demetris, M.D.