Histomorphological Spectrum and Audit of Explant Livers: a 15 year Retrospective Study of 100 cases from a Government Liver Transplant Center

Background: Explant liver histopathology is considered the gold standard for confirming pre-transplant diagnosis and identifying incidental or previously unrecognized liver pathologies.^[1] With a shifting global burden of end-stage liver disease (ESLD) from viral to alcohol- and metabolic-associated etiologies, region-specific histopathological data are essential.^[2,3] However, long-term studies from Indian transplant centers remain scarce.^[4] Our aim is to evaluate the histopathological spectrum of explant livers over a 15-year period and identify rare or incidental etiologies contributing to end stage liver disease. This retrospective descriptive study was conducted at the Department of Pathology, Government Medical College. Explant liver specimens (n=100), received between January 2009 and December 2024, were processed routinely, stained with hematoxylin and eosin, special stains like reticulin and analyzed. Clinical and demographic parameters were correlated with histopathological findings. In our study, the most common age group was 30 – 50 years of age. 83 cases were males and 17 cases were females. The leading etiology was ethanol related cirrhosis followed by decompensated liver disease with portal hypertension, cryptogenic cirrhosis, metabolic associated liver disease. This 15-year audit underscores a shifting etiological profile of liver disease and reflects a rising trend in alcohol and metabolic-associated liver disease.^[2,3]

Keywords: Explant liver, cirrhosis, viral induced cirrhosis, Decompensated liver disease.