Complement Component 4d Immunostaining in Liver Allografts of Patients With De Novo Immune Hepatitis

被引:33
作者
Aguilera, Isabel [1 ]
Manuel Sousa, Jose [2 ]
Gavilan, Francisco [3 ]
Gomez, Lourdes [3 ]
Alvarez-Marquez, Antonia [1 ]
Nunez-Roldan, Antonio [1 ]
机构
[1] Virgen del Roci Univ Hosp, Biomed Inst Seville, Serv Immunol, Seville 41013, Spain
[2] Virgen del Roci Univ Hosp, Biomed Inst Seville, Digest Dis Serv, Seville 41013, Spain
[3] Virgen del Roci Univ Hosp, Biomed Inst Seville, Pathol Serv, Seville 41013, Spain
关键词
C4D DEPOSITS; PERITUBULAR CAPILLARIES; AUTOIMMUNE HEPATITIS; GRAFT DYSFUNCTION; HUMORAL IMMUNITY; REJECTION; TRANSPLANTATION; ANTIBODIES; LYMPHOCYTES; DAMAGE;
D O I
10.1002/lt.22302
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
De novo immune hepatitis (DNIH) is a form of late graft dysfunction after liver transplantation. The fine mechanisms leading to the development of DNIH are not known, and whether this hepatitis is a form of rejection or a result of an auto/alloimmune injury has not been established. In our patients, DNIH was always preceded by the production of donor-specific antibodies against the glutathione S-transferase T1 (GSTT1) enzyme because of a genetic mismatch in which the donors carried the wild-type gene and the recipients displayed the null genotype. Complement component 4d (C4d) immunopositivity in 12 paraffin-embedded liver biopsy samples from 8 patients diagnosed with DNIH associated with anti-GSTT1 antibodies was retrospectively evaluated. Six patients with a diagnosis of chronic rejection (CR) and 7 patients with hepatitis C virus recurrence were included as control groups. Among the patients with DNIH, 7 showed C4d-positive immunostaining localized in the portal tracts, whereas in the tested biopsy samples of the 2 control groups, this staining pattern was absent. Four biopsy samples of the CR group showed C4d-positive sinusoidal staining. This study confirms the activation of the complement pathway in the presence of donor-specific antibodies, which was shown by the deposition of C4d elements in liver biopsy samples of patients with DNIH. The use of C4d as a marker of antibody-mediated rejection in liver allografts in the presence of antidonor antibodies is discussed, and it may contribute to improved differential diagnoses based on biopsy findings. Liver Transpl 17: 779-788, 2011. (C) 2011 AASLD.
引用
收藏
页码:779 / 788
页数:10
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