Division of Transplantation Pathology

The Division of Transplantation Pathology, Department of Pathology presents the following information online as part of our effort to establish links with interested physicians throughout the nation.

The Division of Transplantation Pathology is an integral part of the comprehensive transplant program at the University of Pittsburgh Medical Center. Its mission is to provide up-to-date laboratory services emphasizing continued excellence in patient care, to foster an academic environment devoted to education and training, and to conduct basic and clinically oriented research in transplantation pathology. A nucleus of experienced professionals with expertise in pathology, immunology and molecular biology is actively involved in many transplantation related research projects at the Medical Center.

Consultation Services In Hepatic and Transplantation Pathology

Faculty

Laboratory Services

The Division offers a wide range of laboratory tests and tissue analyses for patients and for experimental studies. Routine histology, immunocytochemistry and in situ hybridization are performed on tissues and fine needle aspirates from patients under consideration for transplantation, native organ resections and post-transplant biopsies. These procedures assure consistency of analysis and continuity of patient care. Post-transplant monitoring assays deal with lymphocyte reactivity and cytokine production and on detection of cytomegalovirus, Epstein-Barr virus, and hepatitis viruses. Procedures for fine needle aspiration analysis have been added to post-transplant immunologic monitoring.

The Tissue Typing Laboratory operates with Central Laboratory Services, Inc., and serves UPMC-HS affiliated hospitals and Children's Hospital of Pittsburgh. These facilities use serologically and molecularly based HLA typing methodologies to gauge donor-recipient compatibility in both solid organ and bone marrow transplantation. Considerable emphasis is placed on the detection and specificity analysis of alloantibodies in sensitized transplant candidates to identify potential donors with suitable HLA types.

Training and Teaching Activities

Drug discovery effort for polyomavirus BK
The Division is strongly devoted to teaching and training in transplantation pathology. Its professional staff directs postdoctoral fellows, graduate students and medical students in various aspects of molecular immunogenetics, transplantation biology and clinical care. Many visitors visit the Division for further training in transplant pathology. An elective three-month rotation program is offered to pathology residents interested in acquiring a basic understanding of the molecular and cellular mechanisms of transplant immunity, allograft rejection, opportunistic infections, organ preservation injury, recurrent disease, drug toxicity, graft versus host disease and lymphoproliferative disease. Special emphasis is placed on the application of modern technologies including flow cytometry, immunostaining, in situ hybridization, gene transcription by polymerase chain reaction and molecular testing for genetic polymorphisms. The Division conducts five weekly conferences on heart, kidney, liver and intestinal transplant pathology and native liver pathology. Another conference in conjunction with Transplant Surgery deals with liver transplant tumors. A weekly Transplant Grand Rounds was initiated this year. A basic research conference is held each week.

Research Activities

The Division has a strong commitment to research in transplantation. The faculty is actively engaged in research projects frequently in collaboration with members of other departments, in particular, Transplant Surgery. Current research activities deal with a variety of projects, including:

  • dendritic cells in microchimerism after organ transplantation and tolerance induction
  • cytokine-induced activation of biliary epithelium
  • immune mechanisms of chronic vasculopathy
  • stress proteins in transplant immunity
  • histocompatibility and liver transplant outcome
  • transplantation of highly sensitized patients
  • immune profiles in bronchoalveolar lavages from lung transplant patients during CMV and bronchiolitis obliterans
  • cellular immunity and treatment of post-transplant lymphoproliferative disease.
  • mechanisms of small intestinal transplant rejection

Telepathology and Internet Resources

BKV infected cells in a transplanted kidney
BKV infected cells in a transplanted kidney
The Division runs a telepathology consultation service for the transplantation program at Istituto Mediterra-neo per i Trapianti e Terapie ad Alta Specializzazione (IsMeTT), in Palermo, Sicily. Additionally, the Division maintains an interactive Internet site called Transplant Pathology Internet Services (TPIS). TPIS is a dynamic, Web-based, collaborative tool for transplant physicians, and an educational resource for health care professionals in the field of Transplantation Medicine. The URL for this resource is: http://tpis.upmc.edu