Characterization of CD4, CD8, CD56 positive lymphocytes and C4d deposits to distinguish acute cellular rejection from recurrent hepatitis C in post-liver transplant biopsies

Ashokkumar Jain, Charlotte Ryan, Ravi Mohanka, Mark Orloff, Peter Abt, Joan Romano, Leah Bryan, Pam Batzold, Parvez Mantry, Adel Bozorgzadeh

Research output: Contribution to journalArticle

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Abstract

Hepatitis C viral (HCV) infection is the most common cause for liver transplantation (LTx) in USA. Hepatitis C viral recurrence in liver allograft is almost universal, which is often difficult to distinguish from acute cellular rejection (ACR). Aim: Aim of the present study is to examine the differences between distribution of CD4, CD8, CD56 positive lymphocytes, and C4d deposits in patients with ACR and recurrent HCV. Patients and methods: As a pilot project, a group of five post-LTx HCV RNA negative patients, strongly suspicious for ACR based on clinical findings and history of medication non-compliance and another group of five post-LTx HCV positive, medication compliant patients with abnormal liver function were retrospectively selected. Liver biopsies of these patients were stained with monoclonal CD4, CD8, CD56, and polyclonal C4d antibodies and compared. Results: Mean CD4, CD8, and CD56 counts in ACR group were 156.7 ± 17.6, 35.4 ± 8.8, and 1.0 ± 1.8/HPF, respectively and were 89.7 ± 41.3, 20.3 ± 23.2, and 0.6 ± 0.9/HPF, respectively in HCV recurrence group. Biopsies of four of five patients with ACR demonstrated moderate to strong C4d staining, whereas all patients with recurrent HCV had none to mild C4d staining. Conclusion: Mean CD4, CD8, and CD56 were similar for acute rejection and recurrent HCV infection. However, 80% of patients with ACR showed moderate to strong staining for C4d and all recurrent HCV patients showed none to mild C4d staining.

Original languageEnglish (US)
Pages (from-to)624-633
Number of pages10
JournalClinical Transplantation
Volume20
Issue number5
DOIs
StatePublished - Sep 1 2006

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CD8-Positive T-Lymphocytes
Hepatitis C
Transplants
Biopsy
Liver
Staining and Labeling
Virus Diseases
Rejection (Psychology)
Recurrence
Medication Adherence
Viral RNA
Liver Transplantation
Allografts

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Jain, Ashokkumar ; Ryan, Charlotte ; Mohanka, Ravi ; Orloff, Mark ; Abt, Peter ; Romano, Joan ; Bryan, Leah ; Batzold, Pam ; Mantry, Parvez ; Bozorgzadeh, Adel. / Characterization of CD4, CD8, CD56 positive lymphocytes and C4d deposits to distinguish acute cellular rejection from recurrent hepatitis C in post-liver transplant biopsies. In: Clinical Transplantation. 2006 ; Vol. 20, No. 5. pp. 624-633.
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abstract = "Hepatitis C viral (HCV) infection is the most common cause for liver transplantation (LTx) in USA. Hepatitis C viral recurrence in liver allograft is almost universal, which is often difficult to distinguish from acute cellular rejection (ACR). Aim: Aim of the present study is to examine the differences between distribution of CD4, CD8, CD56 positive lymphocytes, and C4d deposits in patients with ACR and recurrent HCV. Patients and methods: As a pilot project, a group of five post-LTx HCV RNA negative patients, strongly suspicious for ACR based on clinical findings and history of medication non-compliance and another group of five post-LTx HCV positive, medication compliant patients with abnormal liver function were retrospectively selected. Liver biopsies of these patients were stained with monoclonal CD4, CD8, CD56, and polyclonal C4d antibodies and compared. Results: Mean CD4, CD8, and CD56 counts in ACR group were 156.7 ± 17.6, 35.4 ± 8.8, and 1.0 ± 1.8/HPF, respectively and were 89.7 ± 41.3, 20.3 ± 23.2, and 0.6 ± 0.9/HPF, respectively in HCV recurrence group. Biopsies of four of five patients with ACR demonstrated moderate to strong C4d staining, whereas all patients with recurrent HCV had none to mild C4d staining. Conclusion: Mean CD4, CD8, and CD56 were similar for acute rejection and recurrent HCV infection. However, 80{\%} of patients with ACR showed moderate to strong staining for C4d and all recurrent HCV patients showed none to mild C4d staining.",
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Characterization of CD4, CD8, CD56 positive lymphocytes and C4d deposits to distinguish acute cellular rejection from recurrent hepatitis C in post-liver transplant biopsies. / Jain, Ashokkumar; Ryan, Charlotte; Mohanka, Ravi; Orloff, Mark; Abt, Peter; Romano, Joan; Bryan, Leah; Batzold, Pam; Mantry, Parvez; Bozorgzadeh, Adel.

In: Clinical Transplantation, Vol. 20, No. 5, 01.09.2006, p. 624-633.

Research output: Contribution to journalArticle

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T1 - Characterization of CD4, CD8, CD56 positive lymphocytes and C4d deposits to distinguish acute cellular rejection from recurrent hepatitis C in post-liver transplant biopsies

AU - Jain, Ashokkumar

AU - Ryan, Charlotte

AU - Mohanka, Ravi

AU - Orloff, Mark

AU - Abt, Peter

AU - Romano, Joan

AU - Bryan, Leah

AU - Batzold, Pam

AU - Mantry, Parvez

AU - Bozorgzadeh, Adel

PY - 2006/9/1

Y1 - 2006/9/1

N2 - Hepatitis C viral (HCV) infection is the most common cause for liver transplantation (LTx) in USA. Hepatitis C viral recurrence in liver allograft is almost universal, which is often difficult to distinguish from acute cellular rejection (ACR). Aim: Aim of the present study is to examine the differences between distribution of CD4, CD8, CD56 positive lymphocytes, and C4d deposits in patients with ACR and recurrent HCV. Patients and methods: As a pilot project, a group of five post-LTx HCV RNA negative patients, strongly suspicious for ACR based on clinical findings and history of medication non-compliance and another group of five post-LTx HCV positive, medication compliant patients with abnormal liver function were retrospectively selected. Liver biopsies of these patients were stained with monoclonal CD4, CD8, CD56, and polyclonal C4d antibodies and compared. Results: Mean CD4, CD8, and CD56 counts in ACR group were 156.7 ± 17.6, 35.4 ± 8.8, and 1.0 ± 1.8/HPF, respectively and were 89.7 ± 41.3, 20.3 ± 23.2, and 0.6 ± 0.9/HPF, respectively in HCV recurrence group. Biopsies of four of five patients with ACR demonstrated moderate to strong C4d staining, whereas all patients with recurrent HCV had none to mild C4d staining. Conclusion: Mean CD4, CD8, and CD56 were similar for acute rejection and recurrent HCV infection. However, 80% of patients with ACR showed moderate to strong staining for C4d and all recurrent HCV patients showed none to mild C4d staining.

AB - Hepatitis C viral (HCV) infection is the most common cause for liver transplantation (LTx) in USA. Hepatitis C viral recurrence in liver allograft is almost universal, which is often difficult to distinguish from acute cellular rejection (ACR). Aim: Aim of the present study is to examine the differences between distribution of CD4, CD8, CD56 positive lymphocytes, and C4d deposits in patients with ACR and recurrent HCV. Patients and methods: As a pilot project, a group of five post-LTx HCV RNA negative patients, strongly suspicious for ACR based on clinical findings and history of medication non-compliance and another group of five post-LTx HCV positive, medication compliant patients with abnormal liver function were retrospectively selected. Liver biopsies of these patients were stained with monoclonal CD4, CD8, CD56, and polyclonal C4d antibodies and compared. Results: Mean CD4, CD8, and CD56 counts in ACR group were 156.7 ± 17.6, 35.4 ± 8.8, and 1.0 ± 1.8/HPF, respectively and were 89.7 ± 41.3, 20.3 ± 23.2, and 0.6 ± 0.9/HPF, respectively in HCV recurrence group. Biopsies of four of five patients with ACR demonstrated moderate to strong C4d staining, whereas all patients with recurrent HCV had none to mild C4d staining. Conclusion: Mean CD4, CD8, and CD56 were similar for acute rejection and recurrent HCV infection. However, 80% of patients with ACR showed moderate to strong staining for C4d and all recurrent HCV patients showed none to mild C4d staining.

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