Pathology of Intestinal Transplantation

The transplant pathologist's role in monitoring potential complications occurring within alimentary track transplants is a critical component of the clinical team during their management in the critical posttransplant period. Though there has been only approximately two decades of successful human bowel transplantation, enough progress has been made in the anatomic pathology evaluation of biopsies from transplanted intestine that interpretations of these typically minute and superficial mucosal tissues yields important information as to the status of the graft went done by an experienced pathologist. While routine morphologic evaluations of these paraffin embedded biopsies lends to a relatively specific diagnosis in many cases, the incorporation of critical immunohistochemical and molecular adjunct evaluations of the tissue holds high promise of notably refining and providing a much more specific diagnosis. As such, today's transplant pathologist must go beyond the microscope and be well versed in these new and evolving areas, as well as the clinical medicine associated with these patients, so that a proper integration of all results provides a comprehensive and thorough interpretation.