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. 2020 Jan 13;6(2):e523. doi: 10.1097/TXD.0000000000000966

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Copyright © 2020 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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FIGURE 3. — CJ provokes cholangitis in small partial liver graft. A, Representative HE staining of the graft liver in the 30% CJ and 30% CC groups at 24, 72, and 168 h post-LT. In the 30% CJ group, we observed edematous change and the infiltration of inflammatory cells, including neutrophils, around bile ducts at 24 h post-LT. We observed neutrophil infiltration not only around but also among biliary epithelial cells at 72 h post-LT in the 30% CJ group. Biliary epithelial cells were injured, and their nuclei were swollen at 72 h post-LT in the 30% CJ group. Biliary epithelial cells injury recovered and lamellar periductal fibrosis was observed at 168 h post-LT in the 30% CJ group. In the 30% CC group, neutrophil infiltration was not observed around bile ducts at 24, 72, and 168 h post-LT. The original magnification was ×200 for all images. The scale bar in each panel represents 100 μm. B, Representative liver sections stained by naphthol AS-D chloroacetate esterase at 72 h post-LT in the 30% CJ and 30% CC groups. Many neutrophils were observed around bile ducts in the 30% CJ group. A neutrophil (black arrow) was clearly observed among biliary epithelial cells in the 30% CJ group. Neutrophil infiltration was not observed around bile ducts in the 30% CC group. The original magnification was ×400 for all images. The scale bar in each panel represents 40 μm. C, LDH level in bile, reflecting biliary damage, was significantly higher in the 30% CJ group than in the 30% CC group at 24 and 72 h post-LT. †P < 0.01, Mann-Whitney U test. n = 5/group. D, Intrahepatic mRNA expression of TLR4, a representative endotoxin receptor, was significantly higher in the 30% CJ group than in the 30% CC group at 72 and 168 h post-LT. Intrahepatic TLR4 mRNA expression started to increase at 24 h post-LT in the 30% CJ group, which was not observed in the 30% CC group. *P < 0.05, †P < 0.01, Mann-Whitney U test. n = 5/group. E, Intrahepatic IL-6 mRNA expression was significantly higher in the 30% CJ group than in the 30% CC group at 24 and 72 h post-LT. Re-elevation of intrahepatic IL-6 mRNA expression was observed in the 30% CJ group, which was not observed in the 30% CC group. *P < 0.05, †P < 0.01, Mann-Whitney U test. n = 5/group. 30% CC, arterialized 30% partial liver transplantation with choledocho-choledochostomy; 30% CJ, arterialized 30% partial liver transplantation with choledocho-jejunostomy; CC, choledocho-choledochostomy; CJ, choledocho-jejunostomy; HE, hematoxylin-eosin; IL, interleukin; LDH, Lactate dehydrogenase; LT, liver transplantation; TLR, toll-like receptor.