Immunological Factors and Liver Fibrosis in Pediatric Liver Transplant Recipients
Immunological Factors and Liver Fibrosis in Pediatric Liver Transplant Recipients
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DOI：
10.12659/aot.892544
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发表时间：
2015-05-18
影响因子：
1.1
通讯作者：
Kurowski, Przemyslaw N.
中科院分区：
文献类型：
--
作者：
Markiewicz-Kijewska, Malgorzata;Kalicinski, Piotr;Kurowski, Przemyslaw N.
背景：本研究的目的是回顾性评估儿童肝移植受者的移植物纤维化与特定免疫因素之间的相关性。材料/方法：研究对象为33例活体供体移植术后患者，根据移植后急性排斥发作史分为两组。我们评估肝活检是否存在纤维化、抗体介导的排斥反应、炎症浸润和胆管改变的迹象。我们将这些发现与抗hla抗体的评估联系起来。结果：14例ACR患者中有8例（57%）有纤维化史。在19例无ACR病史的患者中，9例（47%）发现纤维化。47%的纤维化患者有抗hla抗体，而非纤维化患者只有18.75%有抗hla抗体。在3例出现抗体介导排斥反应的患者中，所有患者在移植后2年发生了肝纤维化。我们没有发现任何慢性排斥反应或ductopenia患者。结论：我们认为ACR与正常肝生化受体肝移植中肝纤维化的发生存在相关性。抗hla抗体II类似乎在纤维化的发展中最重要。
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/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.