Re: Transplant info for Histopathology

You will see an increase in requests for same day processing on the transplant patients.( We use a short processing program app. 1 hour.). Seldom is anything other than an H&E required on these patients. When the program first started here FS were only requested when the surgeon was concerned about the viability of the donor liver. Recently the surgeons have been requesting FS on the donor livers with H&E and ORO. At the start of the program here the surgeon biopsied the patients once a week until they were released from the hospital (no longer the case) after that when the liver enzyme test were elevated. Our department was told of the surgeon's intention to do this before the first transplant was performed. As for immunoperoxidase you will probably see a small increase in the number of CMV's ordered, but they will probably be requested on the GI biopsies. The biggest increase in our workload was from patients with end stage liver disease. Those are seldom rushed and usually require a Masson's. You will need to accommodate night and weekend rushes for the transplant patients.

I do remember that when bone marrow transplants were started we saw 30% increase in bone marrow specimens received by the lab in the first 3 months. I don't remember the increase for livers. I do recall the surgeon saying he expected 1 rush specimen a week, we are way past that figure. In 1990 we had an average of 14 liver biopsies a month by 1994 it averaged over 60 a month. I don't have specific figures for recent years. Of course as the number of transplants performed goes up so will your workload.

Rena FaiL AS,HT(ASCP)
Medical University of South Carolina

----- Original Message -----

From: Noreen Gilman

Sent: Friday, August 09, 2002 7:49 AM

Subject: Transplant info for Histopathology

Our medical center is preparing to become an liver transplant center. There is very little information for histopathology such as the necessity for rapid diagnosis, frozen sections, emergency processing programs, immunoperoxidase, etc. Does anyone out there in Histoland have any experience with this and can you give me some idea of what I'll be facing, such as staffing issues, on-call, etc.

Noreen Gilman, BS, HT (ASCP) CLS
Histopathology Supervisor
Broward General Medical Center
Ft. Lauderdale, FL 33316
954.355.5592 Phone
954.355.4139 Fax
954.387.0213 Pager