Małgorzata Markiewicz-Kijewska1, Piotr Kaliciński1, Przemysław Kluge2, Barbara Piątosa3, Irena Jankowska4, Aneta Rękawek3, Ewa Kostecka3, Przemysław N Kurowski3. 1. Department of Pediatric Surgery and Organ Transplantation, Children's Memorial Health Institute, Warsaw, Poland. 2. Department of Pathology, Children's Memorial Health Institute, Warsaw, Poland. 3. Histocompatibility Laboratory, Children's Memorial Health Institute, Warsaw, Poland. 4. Department of Gastroenterology, Hepatology and Feeding Disorder, Children's Memorial Health Institute, Warsaw, Poland.
Abstract
BACKGROUND: The aim of our study was to retrospectively assess any correlation between graft fibrosis and selected immunological factors in pediatric liver transplant recipients. MATERIAL AND METHODS: The study was performed on 33 patients after living related donor transplantation, divided into 2 groups depending on history of acute rejection episodes after transplantation. We assessed liver biopsies for presence of fibrosis, signs of antibody-mediated rejection, inflammatory infiltrations, and changes in bile ducts. We correlated these findings with assessment of anti-HLA antibodies. RESULTS: Among 14 patients with ACR, a history fibrosis was found in 8 patients (57%). In 19 patients without a history of ACR, fibrosis was found in 9 patients (47%). Anti-HLA antibodies were found in 47% of patients with fibrosis and in only 18.75% of patients without fibrosis. Among 3 patients with signs of antibody-mediated rejection, all had fibrosis in the graft 2 years after transplantation. We did not find any patient with chronic rejection or ductopenia. CONCLUSIONS: We suggest that there is a correlation between ACR and development of graft fibrosis present in liver grafts from recipients with normal liver biochemistry. Anti-HLA antibodies class II seems to be most important in development of fibrosis.
BACKGROUND: The aim of our study was to retrospectively assess any correlation between graft fibrosis and selected immunological factors in pediatric liver transplant recipients. MATERIAL AND METHODS: The study was performed on 33 patients after living related donor transplantation, divided into 2 groups depending on history of acute rejection episodes after transplantation. We assessed liver biopsies for presence of fibrosis, signs of antibody-mediated rejection, inflammatory infiltrations, and changes in bile ducts. We correlated these findings with assessment of anti-HLA antibodies. RESULTS: Among 14 patients with ACR, a history fibrosis was found in 8 patients (57%). In 19 patients without a history of ACR, fibrosis was found in 9 patients (47%). Anti-HLA antibodies were found in 47% of patients with fibrosis and in only 18.75% of patients without fibrosis. Among 3 patients with signs of antibody-mediated rejection, all had fibrosis in the graft 2 years after transplantation. We did not find any patient with chronic rejection or ductopenia. CONCLUSIONS: We suggest that there is a correlation between ACR and development of graft fibrosis present in liver grafts from recipients with normal liver biochemistry. Anti-HLA antibodies class II seems to be most important in development of fibrosis.
Authors: Safak Gül-Klein; Anika Kästner; Philipp Konstantin Haber; Felix Krenzien; Simon Wabitsch; Alexander Krannich; Andreas Andreou; Dennis Eurich; Frank Tacke; David Horst; Johann Pratschke; Moritz Schmelzle Journal: J Hepatocell Carcinoma Date: 2021-03-18