FINE-NEEDLE ASPIRATION BIOPSY IN LIVER GRAFTED PATIENTS UNDER CYCLOSPORINE THERAPY

WIDELY USED in kidney transplantation, cyclosporine (CsA) immunosuppressive therapy has improved the prognosis of liver grafted patients as well. In fact the 1-year survival rates have now reached 60% to 70%,' this result being partly due to the drug. However, several causes of liver graft dysfunction stili occur. Rejection, graft infections and drug toxicity offer serious problems in the clinical differential diagnosis, in addition to the surgical complications. Although there have been attempts2'3 in defìning clinical specific features of the individuai conditions, it appears that clinical and biohumoral criteria only do not help in clearing up the diagnosis. Furthermore, it should be re-emphasized that various causes of liver disfunction often coexist. Most centers use clinical and biohumoral parameters together with the histologic examination of liver core biopsies in the monitoring of the postoperative course. Since 1983 a combined protocol, based on liver fine needle aspiration biopsy (FNAB), needle core biopsy (NB), and urinary exfoliative cytology (to detect early nephrotoxicity in such patients) has been used at our institution.