Background: The diagnosis of an underlying liver disease should be made
before a patient is listed for transplantation, but in a significant number of
patients we overlooked a concurrent disease and patient was qualified on the waiting list with the diagnosis of idiopathic liver failure. Aim: To assess the aetiology and outcome of patients with indeterminate origin of chronic and acute liver failure in the authors' institution.
MaterialMethods: From 2001 to 2008, 655 OLTx were performed. In the group of 47 patients, a median age of 43.4±18.2 years - 7% of total group of patients - aetiology of liver failure was unclear before the liver transplantation. Clinicopathological factors, including treatment variables, outcome of liver transplantation and establishment of the final diagnosis of the explanted liver specimen were analyzed.
Results: Our study shows that histopathology expertise can help to clarify the
diagnosis in only about 34% of cases. In analyzed specimens occurred most
frequently: toxic and alcoholic cirrhosis in 7 patients, Wilson's disease in 4
patients, autoimmune hepatitis in 3 patients, acute Budd-Chiari syndrome and viral hepatitis - each in 1 case.
Conclusions: Precise identification of post-transplant specimen is to a great
extent possible, if the pathologist is adequately provided with all essential
clinical and anamnesis' data. Despite of advance in histopathological and
inmmunohistopathological examinations in 4% of patients', aetiology of liver failure still remained unclear.

Keywords: Liver Transplantation