{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:36:25Z","timestamp":1791203785139,"version":"4.2.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":11566,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1984,1]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Ninety-six liver biopsies [32 bone marrow transplant (BMT), 7 pre-BMT, and 57 non-BMT] are reviewed for histological evidence of graft versus host disease (GVHD), based on bile duct atypia and related inflammatory changes. In addition, the presence of cholestasis, piecemeal necrosis, and attachment of lymphocytes to vascular endothelium (endothelialitis) are evaluated. The 57 non-BMT biopsies include examples of viral hepatitis (acute and chronic), nonviral chronic hepatitis, extrahepatic biliary obstruction, cytomegalovirus hepatitis, primary biliary cirrhosis, and orthotopic liver transplant rejection. Although the sensitivity of bile duct damage as an indicator of GVHD appears high (only one probable false negative was noted), there is considerable overlap between the changes of GVHD and occasional cases of acute and chronic hepatitis and extrahepatic biliary obstruction. Nine of the 57 non-BMT biopsies (15%) were felt to be consistent with GVHD and represent \u201cfalse positives\u201d. Despite this relative lack of specificity, analysis of several features in combination provided clues to improve accuracy of diagnosis. The findings of extensive bile duct damage with minimal inflammatory changes is characteristic of GVHD. Possibly more predictive is the presence of endothelialitis of portal or central veins, which was seen in only three non-BMT biopsies, being present in eight cases of GVHD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.1840040122","type":"journal-article","created":{"date-parts":[[2008,8,22]],"date-time":"2008-08-22T13:52:03Z","timestamp":1219413123000},"page":"123-130","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":142,"title":["Hepatic Graft Versus Host Disease: A Study of the Predictive Value of Liver Biopsy in Diagnosis"],"prefix":"10.1097","volume":"4","author":[{"given":"Dale C.","family":"Snover","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally A.","family":"Weisdorf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norma K.","family":"Ramsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Mcglave","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Kersey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1002\/hep.1840040122-BIB1","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1056\/NEJM197504172921605","article-title":"Bone marrow transplantation","volume":"292","author":"Thomas","year":"1975","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.1840040122-BIB2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/S0046-8177(71)80006-0","article-title":"Graft versus host reactions following transplantation of allogeneic hematopoietic cells","volume":"2","author":"Kersey","year":"1971","journal-title":"Hum Pathol"},{"key":"10.1002\/hep.1840040122-BIB3","first-page":"179","article-title":"Graft versus host disease: morphologic variation and differential diagnosis in eight cases of HLA matched bone marrow transplantation","volume":"63","author":"Kruger","year":"1971","journal-title":"Am J Pathol"},{"key":"10.1002\/hep.1840040122-BIB4","first-page":"367","article-title":"Histopathology of graft versus host reaction (GVHD) in human recipients of marrow from HLA-matched sibling donors","volume":"6","author":"Lerner","year":"1974","journal-title":"Transplant Proceed"},{"key":"10.1002\/hep.1840040122-BIB5","first-page":"291","article-title":"The pathology of bone marrow transplantation","volume":"9","author":"Slavin","year":"1974","journal-title":"Pathol Ann"},{"key":"10.1002\/hep.1840040122-BIB6","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/0090-1229(73)90005-6","article-title":"The graft versus host reaction in man after bone marrow transplantation: pathology, pathogenesis, clinical features and implications","volume":"1","author":"Slavin","year":"1973","journal-title":"Clin Immunol Immunopathol"},{"key":"10.1002\/hep.1840040122-BIB7","first-page":"37","article-title":"Graft versus host disease in allogeneic marrow transplantation","volume":"17","author":"Gale","year":"1980","journal-title":"Biology of bone marrow transplantation, ICN-UCLA Symposia on Molecular and Cellular Biology"},{"key":"10.1002\/hep.1840040122-BIB8","first-page":"675","article-title":"The pathology of the graft versus host reaction (GVHR) in adults receiving bone marrow transplants","volume":"8","author":"Woodruff","year":"1976","journal-title":"Transplant Proc"},{"key":"10.1002\/hep.1840040122-BIB9","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/0016-5085(80)90681-2","article-title":"The diagnostic accuracy of the rectal biopsy in acute graft versus host disease: a prospective study of thirteen patients","volume":"78","author":"Epstein","year":"1980","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840040122-BIB10","first-page":"621","article-title":"The skin biopsy in the diagnosis of acute graft versus host disease in man","volume":"89","author":"Sale","year":"1977","journal-title":"Am J Pathol"},{"key":"10.1002\/hep.1840040122-BIB11","first-page":"369","article-title":"Pathology of liver with bone marrow transplantation: effects of busulfan, carmustine, acute graft versus host disease and cytomegalovirus infection","volume":"99","author":"Beschorner","year":"1980","journal-title":"Am J Pathol"},{"key":"10.1002\/hep.1840040122-BIB12","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1136\/gut.23.6.465","article-title":"Liver disease after bone marrow transplantation","volume":"23","author":"Farthing","year":"1982","journal-title":"Gut"},{"key":"10.1002\/hep.1840040122-BIB13","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1136\/jcp.33.4.344","article-title":"Histopathological changes in the liver after allogeneic bone marrow transplantation","volume":"33","author":"Sloane","year":"1980","journal-title":"J Clin Pathol"},{"key":"10.1002\/hep.1840040122-BIB14","doi-asserted-by":"crossref","first-page":"646","DOI":"10.7326\/0003-4819-59-5-646","article-title":"Sclerosing hyaline necrosis of the liver in the chronic alcoholic: a recognizable clinical syndrome","volume":"59","author":"Edmundson","year":"1963","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.1840040122-BIB15","first-page":"471","article-title":"The pathology of fatal epidemic hepatitis","volume":"20","author":"Lucke","year":"1944","journal-title":"Am J Pathol"},{"key":"10.1002\/hep.1840040122-BIB16","first-page":"447","article-title":"The pathology of viral hepatitis","volume":"106","author":"Popper","year":"1972","journal-title":"Can Med Assoc J"},{"key":"10.1002\/hep.1840040122-BIB17","first-page":"218","volume-title":"The liver","author":"Ishak","year":"1973"},{"key":"10.1002\/hep.1840040122-BIB18","first-page":"500","volume-title":"Diseases of the liver","author":"Mosley","year":"1975"},{"key":"10.1002\/hep.1840040122-BIB19","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1002\/hep.1840010511","article-title":"Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis","volume":"1","author":"Knodell","year":"1981","journal-title":"Hepatology"},{"key":"10.1002\/hep.1840040122-BIB20","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/0002-9343(80)90380-0","article-title":"Chronic graft versus host syndrome in man: a long-term clinicopathologic study of twenty Seattle patients","volume":"69","author":"Shulman","year":"1980","journal-title":"Am J Med"},{"key":"10.1002\/hep.1840040122-BIB21","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1097\/00007890-197808000-00009","article-title":"Histopathology of hepatic acute graft versus host disease in the dog: a double blind study confirms the specificity of small bile duct lesions","volume":"26","author":"Sale","year":"1978","journal-title":"Transplantation"},{"key":"10.1002\/hep.1840040122-BIB22","doi-asserted-by":"crossref","first-page":"158","DOI":"10.7326\/0003-4819-90-2-158","article-title":"Veno-occlusive disease of the liver after allogeneic bone marrow transplantation: possible association with graft versus host disease","volume":"90","author":"Berk","year":"1979","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.1840040122-BIB23","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1016\/0016-5085(80)90911-7","article-title":"An analysis of hepatic venoocclusive disease and centrilobular hepatic degeneration following bone marrow transplantation","volume":"79","author":"Shulman","year":"1980","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840040122-BIB24","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/S0046-8177(72)80076-5","article-title":"Abnormal bile duct epithelium in chronic aggressive hepatitis and primary biliary cirrhosis","volume":"3","author":"Christoffersen","year":"1972","journal-title":"Hum Pathol"},{"key":"10.1002\/hep.1840040122-BIB25","first-page":"336","article-title":"Non-suppurative destructive chronic cholangitis and chronic hepatitis","volume":"3","author":"Popper","year":"1970","journal-title":"Prog Liver Dis"},{"key":"10.1002\/hep.1840040122-BIB26","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1699-0463.1969.tb03269.x","article-title":"Abnormal bile duct epithelium in liver biopsies with histological signs of viral hepatitis","volume":"76","author":"Poulsen","year":"1969","journal-title":"Acta Pathol Microbiol Scand"},{"key":"10.1002\/hep.1840040122-BIB27","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S0046-8177(72)80075-3","article-title":"Abnormal bile duct epithelium in chronic aggressive hepatitis and cirrhosis: a review of morphology and clinical, biochemical and immunologic features","volume":"3","author":"Poulsen","year":"1972","journal-title":"Hum Pathol"},{"key":"10.1002\/hep.1840040122-BIB28","first-page":"659","article-title":"The occurrence and significance of abnormal bile duct epithelium in cirrhosis","volume":"80A","author":"Poulsen","year":"1972","journal-title":"Acta Pathol Microbiol Scand"},{"key":"10.1002\/hep.1840040122-BIB29","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/0002-9343(59)90188-3","article-title":"Liver cell necrosis in chlorpromazine jaundice (allergic cholangiolitis): a serial study of twenty-six biopsy specimens in nine patients","volume":"27","author":"Zelman","year":"1959","journal-title":"Am J Med"},{"key":"10.1002\/hep.1840040122-BIB30","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1093\/ajcp\/41.2.126","article-title":"Hepatic alterations in obstructive jaundice","volume":"41","author":"Gall","year":"1964","journal-title":"Am J Clin Pathol"},{"key":"10.1002\/hep.1840040122-BIB31","first-page":"571","article-title":"Histological changes in liver biopsies from patients with surgical bile duct disorders","volume":"78A","author":"Poulsen","year":"1970","journal-title":"Acta Pathol Microbiol Scand"},{"key":"10.1002\/hep.1840040122-BIB32","first-page":"289","article-title":"Ductular damage in liver transplant rejection: its similarity to that of primary biliary cirrhosis and graft versus host disease","volume":"16","author":"Fennell","year":"1981","journal-title":"Pathol Ann"},{"key":"10.1002\/hep.1840040122-BIB33","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/1523-1747.ep12543412","article-title":"Human graft versus host disease","volume":"74","author":"Parkman","year":"1980","journal-title":"J Invest Dermatol"},{"key":"10.1002\/hep.1840040122-BIB34","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1084\/jem.155.5.1501","article-title":"Allosuppressor and allohelper T cells in acute and chronic graft versus host disease I: alloreactive suppressor cells rather than killer T cells appear to be the decisive effector cells in lethal graft versus host disease","volume":"155","author":"Rolink","year":"1982","journal-title":"J Exp Med"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.1840040122","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-198401000-00022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T11:15:47Z","timestamp":1733051747000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-198401000-00022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,1]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1984]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.1840040122","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[1984,1]]}}}